PR interval as a predictor of syncope in tilt-up testing in adolescents and young adults

Abstract Background Syncope, as the most frequent consciousness disorder, is very common in young individuals. The aim of this study was to analyze ECG parameters and clinical properties obtained during tilt-up testing in 12 to 30-year-old subjects. We enrolled a total of 142 patients from our outpatient clinic (39 males, 103 females) with a true positive tilt-up test and analyzed ECG records obtained during tilt-testing. Data were stratified according to the age, gender, and type of syncope. Results PR interval shortening preceding syncope was found in all syncope types, irrespective of the gender. All types of syncope were more frequent in women (72.5%). Mixed syncope type was found to be the most common (47.18%). Male and female subjects differed in initial heart rate (71.56 vs 76.23/min, p=0.05), as well as heart rate dynamics during tilt-up testing. A gender difference was also found in systolic blood pressure (116.92 vs 110.44 mmHg, p<0.01), time to syncope onset (20.77 vs. 16.44 min, p=0.03), and the total number of syncopal episodes in patient history (2.79 vs. 4.62, p<0.05). Subjects with cardioinhibitory syncope had the longest PR interval (average 154.3 ms). PR interval prolongation and loss of variability during tilt-up testing positively correlated with aging (r=0.22, p<0.05). Nodal rhythm was found in 8 patients. Conclusion PR interval shortening on ECG tracings during a tilt-up test can be found in all subtypes of vasovagal syncope, thereby contrasting previous reports that these changes are a hallmark of the cardioinhibitory type of syncope. PR shortening, if observed during ECG monitoring, could be a potential predictor of syncope.

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Assessment of Nonlinear Heart Rate Dynamics after Beating-Heart Revascularization

The Heart Surgery Forum ◽

10.1532/hsf98.20081116 ◽

2009 ◽

Vol 12 (1) ◽

pp. E10-E16 ◽

Cited By ~ 10

Author(s):

Jus Ksela ◽

Piotr Suwalski ◽

Jurij Matija Kalisnik ◽

Viktor Avbelj ◽

Grzegorz Suwalski ◽

...

Keyword(s):

Heart Rate ◽

Beating Heart ◽

Nonlinear Heart Rate Dynamics ◽

Heart Rate Dynamics

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Heart Rate Dynamics After Acute Cocaine Administration

Journal of Cardiovascular Pharmacology ◽

10.1097/00005344-199203000-00024 ◽

1992 ◽

Vol 19 (3) ◽

pp. 453-459 ◽

Cited By ~ 4

Author(s):

Alan Garfinkel ◽

Sheryl L. Raetz ◽

Ronald M. Harper

Keyword(s):

Heart Rate ◽

Cocaine Administration ◽

Heart Rate Dynamics

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Associations between left bundle branch block with different PR intervals, QRS durations, heart rates and the risk of heart failure: a register-based cohort study using ECG data from the primary care setting

Open Heart ◽

10.1136/openhrt-2020-001425 ◽

2021 ◽

Vol 8 (1) ◽

pp. e001425

Author(s):

Marc Meller Søndergaard ◽

Johannes Riis ◽

Karoline Willum Bodker ◽

Steen Møller Hansen ◽

Jesper Nielsen ◽

...

Keyword(s):

Heart Failure ◽

Primary Care ◽

Heart Rate ◽

Left Bundle Branch Block ◽

Bundle Branch Block ◽

Increased Risk ◽

Pr Interval ◽

Qrs Duration ◽

The Impact

AimLeft bundle branch block (LBBB) is associated with an increased risk of heart failure (HF). We assessed the impact of common ECG parameters on this association using large-scale data.Methods and resultsUsing ECGs recorded in a large primary care population from 2001 to 2011, we identified HF-naive patients with a first-time LBBB ECG. We obtained information on sex, age, emigration, medication, diseases and death from Danish registries. We investigated the association between the PR interval, QRS duration, and heart rate and the risk of HF over a 2-year follow-up period using Cox regression analysis.Of 2471 included patients with LBBB, 464 (18.8%) developed HF during follow-up. A significant interaction was found between QRS duration and heart rate (p<0.01), and the analyses were stratified on these parameters. Using a QRS duration <150 ms and a heart rate <70 beats per minute (bpm) as the reference, all groups were statistically significantly associated with the development of HF. Patients with a QRS duration ≥150 ms and heart rate ≥70 bpm had the highest risk of developing HF (HR 3.17 (95% CI 2.41 to 4.18, p<0.001). There was no association between the PR interval and HF after adjustment.ConclusionProlonged QRS duration and higher heart rate were associated with increased risk of HF among primary care patients with LBBB, while no association was observed with PR interval. Patients with LBBB with both a prolonged QRS duration (≥150 ms) and higher heart rate (≥70 bpm) have the highest risk of developing HF.

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Identification of heart rate dynamics during moderate-to-vigorous treadmill exercise

BioMedical Engineering OnLine ◽

10.1186/s12938-015-0112-7 ◽

2015 ◽

Vol 14 (1) ◽

Cited By ~ 18

Author(s):

Kenneth J. Hunt ◽

Simon E. Fankhauser ◽

Jittima Saengsuwan

Keyword(s):

Heart Rate ◽

Treadmill Exercise ◽

Heart Rate Dynamics

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Spectral analysis of heart rate in vasovagal syncope: The autonomic nervous system in vasovagal syncope

Clinical Autonomic Research ◽

10.1007/bf01829016 ◽

1993 ◽

Vol 3 (4) ◽

pp. 261-269 ◽

Cited By ~ 17

Author(s):

A. Baharav ◽

M. Mimouni ◽

T. Lehrman-Sagie ◽

S. Izraeli ◽

S. Akselrod

Keyword(s):

Heart Rate ◽

Nervous System ◽

Spectral Analysis ◽

Autonomic Nervous System ◽

Vasovagal Syncope ◽

Autonomic Nervous

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Estimation of Heart Rate Variability Changes during Different Visual Stimulations Using Non-invasive Continuous ECG Monitoring System

2009 International Joint Conference on Bioinformatics, Systems Biology and Intelligent Computing ◽

10.1109/ijcbs.2009.75 ◽

2009 ◽

Cited By ~ 2

Author(s):

Wanqing Wu ◽

Jungtae Lee ◽

Haifeng Chen

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Monitoring System ◽

Ecg Monitoring ◽

Non Invasive

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Nonlinear analysis of heart rate dynamics in hyperthyroidism

Physiological Measurement ◽

10.1088/0967-3334/28/4/008 ◽

2007 ◽

Vol 28 (4) ◽

pp. 427-437 ◽

Cited By ~ 4

Author(s):

Jin-Long Chen ◽

Yin-Jiun Tseng ◽

Hung-Wen Chiu ◽

Tzu-Chien Hsiao ◽

Woei-Chyn Chu

Keyword(s):

Heart Rate ◽

Nonlinear Analysis ◽

Heart Rate Dynamics

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Complex and irregular heart rate dynamics in fetuses compromised by maternal anemia as a high-risk pregnancy

Journal of Perinatal Medicine ◽

10.1515/jpm-2014-0104 ◽

2015 ◽

Vol 43 (6) ◽

Cited By ~ 2

Author(s):

Young-Sun Park ◽

Jeong-Kyu Hoh

Keyword(s):

Heart Rate ◽

High Risk ◽

Approximate Entropy ◽

Risk Groups ◽

Adverse Outcomes ◽

Maternal Anemia ◽

Risk Pregnancy ◽

Heart Rate Dynamics ◽

Study Population ◽

Normal Controls

AbstractTo examine how complex and irregular fetal heart rate (FHR) dynamics differ between fetuses of normal pregnancies and those of pregnancies complicated by maternal anemia (MA), and to place this in the context of high-risk pregnancies.Our study population consisted of 97 pregnant women affected by MA, 118 affected by pregnancy-induced hypertension (PIH), 88 affected by gestational diabetes mellitus (GDM), 53 with preterm premature rupture of membranes (pPROM), and 356 normal pregnancies as controls. We calculated approximate entropy (ApEn), sample entropy (SampEn), and correlation dimension (CD) to quantify irregularity and the chaotic dynamics of each FHR time series.The ApEn in the fetuses of the MA and PIH groups was significantly lower than that of the normal controls (P<0.05). The SampEn was significantly lower in the high-risk groups, except for the pPROM group, than in the normal controls (P<0.05). The CD in the PIH and severe MA groups was significantly lower than that of the normal controls (P<0.05, respectively). In the MA group, the dynamic indices showed a highly significant positive correlation with hemoglobin (Hb) levels (P<0.0001).The decreased complexity and/or irregularity in the FHR from pregnancies with MA may reflect abnormalities in the complex, integrated cardiovascular control. The irregularity and complexity of the FHR increased together with Hb levels in pregnancies with MA. Our data suggest that the integrity of the nervous system in the fetuses compromised by severe MA might result directly in adverse outcomes.

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