Key result
Abnormal heart rate turbulence is present in 100% of sustained VT or VF patients.
Why the study?
Changes in autonomic neural control mechanisms before malignant ventricular arrhythmias are not well characterized using heart rate variability and turbulence.
Does heart rate turbulence analysis better detect transient alterations in autonomic control mechanisms preceding malignant ventricular arrhythmias compared to heart rate variability?
Observational (n=75)
Does heart rate turbulence analysis better detect transient alterations in autonomic control mechanisms preceding malignant ventricular arrhythmias compared to heart rate variability?
Absolute Event Rate: 100% vs 50%
Heart rate turbulence analysis is more sensitive than heart rate variability for detecting transient autonomic alterations that may trigger malignant ventricular arrhythmias.
Abnormal HRT may flag imminent VT/VF when HRV does not; leaves open its value for real-time risk stratification.
BackgroundTo evaluate the changes in autonomic neural control mechanisms before malignant ventricular arrhythmias, we measured heart rate variability (HRV) and heart rate turbulence (HRT) in patients with ventricular tachycardia or fibrillation (Group I; n=6), non sustained ventricular tachycardia (Group II; n=32), frequent premature ventricular beats (Group III; n=26) and with ICD implantation (Group IV; n=11).MethodsTime domain parameters of HRV and turbulence onset (TO) and slope (TS) were cal-culated on 24 hour Holter recordings. Normal values were: SDNN > 70 msec for HRV, TO <0% and TS >2.5 msec/RR-I for HRTResultsWhereas SDNN was within normal range and similar in all study groups, HRT parameters were significantly different in patients who experienced VT/VF during Holter recording. Abnormal TO and/or TS were present in 100% of Group I patients and only in about 50% of Group II and IV On the contrary, normal HRT parameters were present in 40–70% of Group II, III and IV patients and none of Group I.ConclusionsThese data suggest that HRT analysis is more suitable than HRV to detect those transient alterations in autonomic control mechanisms that are likely to play a major trigger role in the genesis of malignant cardiac arrhythmias.
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Lombardi et al. (2007) conducted an observational in Ventricular arrhythmias (n=75). Ventricular tachycardia or fibrillation vs. Other ventricular arrhythmias or ICD implantation was evaluated on Abnormal turbulence onset (TO) and/or turbulence slope (TS). Abnormal heart rate turbulence parameters were present in 100% of patients with ventricular tachycardia or fibrillation, compared to about 50% of patients with non-sustained VT or ICDs.
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