Heart Rate Turbulence in Patients With Arterial Hypertension With Ventricular Arrhythmia

The search of risk predictors for cardiac mortality is one of the most actual problems in modern research medicine. The application of heart rate turbulence (HRT) is currently one of the methods of sudden cardiac death prognosis. The HRT method is based on assessment of the ability of rhythm independent regulation systems (first of all, baroreflex system) for fast compensation of the intracardiac haemodynamic changes caused by ventricular violations of heart rhythm. The concept of the HRT method was first introduced to the medical community by George Schmidt and his colleagues from the Munich University of Technology in 1999. George Schmidt’s research team suggested two HRT characteristics: turbulence onset (TO) and turbulence slope (TS). TO is a rate of sinus rhythm acceleration following VE, and TS is an intensity of sinus rhythm deceleration. The values TO 2.5 mc/RR are generally considered as normal, therefore TO > 0 % and TS < 2.5 mc/RR are abnormal. The sinus rhythm acceleration following a short-term heart rate decrease is considered as a physiological response to VE. The article presents the analysis of the turbulence parameters in patients with arterial hypertension and the study of the possible changes of TO and TS associated with severe arterial hypertension, myocardial infarction, and also present stable stenocardia of tension. The interrelation of heart rate turbulence with other known risk factors of sudden death (heart rate variability, circadian profile of a heart rhythm, quantity ventricular extrasystole) is described.