Heart rate levels and ventricular ectopic activity during cardiac rehabilitation

1980 ◽  
Vol 100 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Maarten Simoons ◽  
Cees Lap ◽  
Jan Pool
2014 ◽  
Vol 71 (10) ◽  
pp. 925-930 ◽  
Author(s):  
Aneta Boskovic ◽  
Natasa Belada ◽  
Bozidarka Knezevic

Background/Aim. Depressed heart rate variability (HRV) indicating autonomic disequilibrium and propensity to ventricular ectopy can be useful for risk stratification in patients following acute myocardial infarction (AIM). The aim of the study was to assess heart rate variability as a predictor of allcause mortality in post-infarction patients. Methods. We analyzed the 24-hour electrocardiographic (ECG) recordings of 100 patients (80 males) during hospitalization for AIM. The mean age of patients was 56.99 + 11.03 years. Time domain heart rate variability analysis was obtained from 8 to 13 days after index infarction by mean of a 24- hour ECG recording, and the calculated parameters were: standard deviation of all normal to normal RR intervals (SDNN), RRmax-RRmin (difference between the longest RR interval and the shortest RR interval), mean RR interval. We also analyzed ventricular premature complexes from the ECG data. The patients underwent clinical evaluation, laboratory tests and echocardiography. Results. Within a oneyear follow-up period 11 patients experienced death, 10 of them because of cardiac reason and one because of stroke. There were significantly lower values of SDNN (60.55 ? 12.84 ms vs 98.38 ? 28.21 ms), RRmax-RRmin (454.36 ? 111.00 ms vs 600.99 ? 168.72 ms) and mean RR interval (695.82 ? 65.87 ms vs 840.07 ? 93.97 ms) in deceased patients than in the survivors, respectively (p < 0.01). The deceased patients were of higher mean age, with lower left ventricular ejection fraction (0.46 ? 0.05 vs 0.56 ? 0.06 in survivors), and more frequent clinical signs of heart failure and ventricular ectopic activity (> 10VPCs/h; p < 0.01). Multivariate Cox analysis showed that SDNN was a significant, independent predictor of all-cause mortality in postinfarction patients. The other independent predictors were clinical signs of heart failure - Killip class II and III and ventricular ectopic activity. Conclusion. Depressed HRV is an independent predictor of mortality in post-infarction patients and may provide useful additional prognostic information in non-invasive risk stratification of these patients.


1989 ◽  
Vol 7 ◽  
pp. S34-35 ◽  
Author(s):  
Carmine Cardillo ◽  
Vincenzo Musumeci ◽  
Nadia Mores ◽  
Giuseppe Guerrera ◽  
Domenico Melina ◽  
...  

1994 ◽  
Vol 27 ◽  
pp. 179-181 ◽  
Author(s):  
Mahendra K. Mandawat ◽  
David R. Wallbridge ◽  
Stuart D. Pringle ◽  
Abdulla A.S. Riyami ◽  
Shahid Latif ◽  
...  

2015 ◽  
Vol 17 (2) ◽  
pp. 41
Author(s):  
N. F. Yakovleva ◽  
A. V. Yakovlev ◽  
S. V. Ponomarev ◽  
A. K. Snegirkova ◽  
I. M. Felikov ◽  
...  

The aim of the study was to investigate the intensity of a number of risk factors resulting in cardiovascular complications, such as body mass index (BMI), level of mean arterial pressure (MAP), left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF) and also ECG data (heart rate variability and ventricular ectopic activity) depending on the severity of obstructive respiratory disturbances during sleep. 76 patients with obstructive sleep apnea syndrome (OSAS) were included in the study. 38 patients with a severe form of OSAS underwent prolonged apparatus treatment which included generating positive pressure in their upper airways. After 4-month treatment the patients of this group underwent another examination to estimate all the parameters studied. Examination of patients with OSAS revealed that a number of indices (BMI, LVMI and MAP) showing the intensity of basic modified cardiovascular risk factors, such as obesity and arterial hypertension, correlate to the level of obstructive respiratory disturbances during sleep, which was estimated according to apnea-hypopnea index (AHI). Twenty-four-hour ECG monitoring of patients with OSAS showed a tendency for a decrease in heart rate variability and an increase in ventricular ectopic activity in patients with more apparent obstructive respiratory disturbances during sleep and with negative disease dynamics against the background of CPAP therapy.


2021 ◽  
Vol 18 (3) ◽  
pp. 147916412110201
Author(s):  
Katarzyna Szmigielska ◽  
Anna Jegier

The study evaluated the influence of cardiac rehabilitation (CR) on heart rate variability (HRV) in men with coronary artery disease (CAD) with and without diabetes. Method: The study population included 141 male CAD patients prospectively and consecutively admitted to an outpatient comprehensive CR program. Twenty-seven patients with type-2 diabetes were compared with 114 males without diabetes. The participants performed a 45-min cycle ergometer interval training alternating 4-min workload and a 2-min active restitution three times a week for 8 weeks. The training intensity was adjusted so that the patient’s heart rate achieved the training heart rate calculated according to the Karvonen formula. At the baseline and after 8 weeks, all the patients underwent the HRV assessment. Results: HRV indices in the patients with diabetes were significantly lower as compared to the patients without diabetes in SDNN, TP, LF parameters, both at the baseline and after 8 weeks of CR. After 8 weeks of CR, a significant improvement of TP, SDNN, pNN50% and HF occurred in the patients without diabetes, whereas in the patients with diabetes only HF component improved significantly. Conclusions: As regards HRV indices, CR seems to be less effective in patients with CAD and type-2 diabetes.


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
LE Estrada Martinez ◽  
JA Lara Vargas ◽  
JA Pineda Juarez ◽  
JD Morales Portano ◽  
JB Gomez Alvarez ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Introduction  Due to the increase in global prevalence of degenerative valve disease, aortic stenosis (AS) has played a preponderant role in the cardiovascular scenario, especially in patients undergoing transcatheter aortic valve replacement (TAVR). An alternative management for this patients are the cardiac rehabilitation programs (CRP); however, their effect has not been completely understood, both in exercise capacity and quality of life, but neither in the improvement of cardiopulmonary performance and other cardiovascular outcomes.  Purpose: To evaluate the effect of the CRP on exercise tolerance and cardiopulmonary performance in patients with AS undergoing TAVR.  Methods: A cohort study was conducted including 26 patients with AS undergoing TAVR and divided into an intervention group who performed a 4-week supervised training program in the Cardiac Rehabilitation Service and a control group to whom instructions and recommendations to performed unsupervised exercise at home were given. Demographic and clinical data (VO2Max, METS12, oxygen pulse, heart rate, double product, left ventricular ejection fraction, body mass index) were collected at baseline and after a 4-week follow-up. Results: 15 patients were included in the intervention group and 11 patients in the control group. There were no baseline significant differences between groups. After the intervention, significant differences were observed in the METS 12 final gain variable between the control and intervention group (4.55 vs 3.1 p = 0.01). Intergroup analysis showed significant differences (percentage changes) in the intervention group with an increase of METS12 (67.4%, p = 0.001), oxygen pulse (18.21%, p = 0.01), final METS (39.47% p = 0.001) and a decrease in VO2 recovery time (-12.5%, p = 0.05), in the ergometric performance index by heart rate (-38.17%, p = 0.001) and by double product (-38.1%, p = 0.001). Conclusions  A 4-week cardiac rehabilitation program is effective to improve exercise tolerance and cardiopulmonary response in patients with AS undergoing TAVR; improvement was statistically significant in METS12, oxygen pulse, VO2 recovery time, METS-load and ergometric performance index for heart rate and double product. METS12 final gain was statistically significant in intervention group in comparison with the control group. Abstract Figure. Control vs Intervention Group (METS12)


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Catherine F Notarius ◽  
Daniel A Keir ◽  
Mark B Badrov ◽  
Philip J Millar ◽  
Paul Oh ◽  
...  

Introduction: Elevated muscle sympathetic nerve activity (MSNA) both at rest and during dynamic cycling relates inversely to peak oxygen uptake (VO 2peak ) in patients with heart failure due to a reduced ejection fraction (HFrEF). We observed a drop in MSNA both rest (-6±2 bursts/min) and mild exercise (-4±2) in HFrEF patients after 6 months of cardiac rehabilitation. Hypothesis: We hypothesized that after training those HFrEF patients with LOW VO2peak (less than median 74% of age predicted) would have a larger decrease in MSNA during dynamic exercise than those with HIGH VO2peak (over 74%). Methods: In 21 optimally treated HFrEF patients (5 Female) (13 HIGH: mean VO 2peak =26 ml·kg/min; 98% of predicted; 8 LOW VO 2peak =12; 50%) we assessed VO 2peak (open-circuit spirometry), heart rate variability (HRV) and fibular MSNA (microneurography) at rest, during 1-leg cycling (2 min each of mild and moderate intensity upright 1-leg cycling, n=19) and recovery before and after 6 months of exercise training (45 min aerobic exercise, 5 days/ wk at 60-70 % of VO 2peak; and resistance training 2 days/wk). Results: HIGH and LOW groups had similar age (63±3 vs 63±4 years) , LVEF (30±2 vs 28±3%), BMI, resting heart rate (HR), blood pressure and MSNA (52±3 vs 50±3 bursts/min). Training increased VO 2peak in both groups (main effect P=0.009), with no group difference in HR response or ratings of perceived exertion. MSNA at rest tended to decrease after training in the HIGH but not LOW group (interaction P=0.08). MSNA during cycling increased in both HIGH (P=0.04) and LOW (P<0.001) groups but was blunted post-training in the HIGH group only (P=0.04 vs. 0.90 in LOW). Training-induced sympatho-inhibition during exercise recovery occurred in the HIGH but not LOW group (interaction P=0.01). In contrast, HRV was not improved by training in either group. Conclusions: Contrary to our hypothesis, the sympatho-inhibitory effect of 6 months of exercise-based cardiac rehabilitation favours HFrEF patients with an already normal VO 2peak . This suggests that increasing initially low VO 2peak may be insufficient to trigger beneficial exercise and recovery autonomic modulation and altered training paradigms may be required in such patients. Funded by Canadian Institutes for Health Research (CIHR)


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