RESEARCH ON CARDIAC ARRHYTHMIA AND HEART RATE VARIABILITY BASED ON 24- HOUR HOLTER ECG IN ELDERLY PATIENTS WITH DILATED CARDIOMYOPATHY

2014 ◽  
pp. 40-47
Author(s):  
Vu Xuan Tho Doan ◽  
Thi Bich Thuan Le
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Elderly Patients ◽  
Dilated Cardiomyopathy ◽  
Cardiac Arrhythmia ◽  
Sinus Bradycardia ◽  
Control Group ◽  
Case Group ◽  
Holter Ecg

Objectives: Study several parameters of cardiac arrhythmia and heart rate variability in elderly patients with dilated cardiomyopathy (DCM), investigate the relationship and correlation between these parameters with NYHA functional heart failure class, EF, LVDd in elderly patients with DCM. Subjects and methods: 30 patients with DCM undergone treatment in Cardiovascular Department. Their ages were ≥ 60. These patients were diagnosed heart failure according to Framingham criteria and DCM according to WHO/ISFC criteria. 24-hour Holter ECG was the method used to analyse cardiac arrhythmia as well as heart rate variability (HRV). These parameters were compared with those considered normal of 81 people. Results: Sinus bradycardia accounted for 6.7%, sinus tachycardia 96.7%, sinus pause 13.3%, premature ventricular contraction 76.7%, supraventricular tachycardia 6.7%, ventricular tachycardia 40%. Lown’s classification: Lown’s class I undertook 46.7%, Lown’s class II 53.3%, Lown’s class III 23.3%, Lown’s class IVA 63.3%, Lown’s class IVB 36.7%, V 6.7%, p < 0.01. HRV indices: SDNN: 57.93 ± 16.99 ms, SDANN: 47.33 ± 16.69 ms, SDNNidx: 31.83 ± 11.00 ms, rMSSD: 19.87 ± 4.39 ms, pNN50: 3.67 ± 2.88%, the parameters acquired from case group were lower than those of control group with statistical difference (p < 0.0001). HRV decreased in proportion to NYHA functional heart failure class and LVEF. There was proportional correlation between LVEF with SDNN (r=0.77, p < 0.01), SDANN (r=0.76, p<0.01), SDNNidx (r=0.66, p<0.01), rMSSD (r=0.58, p<0.01), and pNN50 (r=0.69, p<0.01). Conclusion: 24-hour Holter ECG was valuable in detecting cardiac arrhythmia and HRV in elderly patients with DCM. This method also contributed to the following up, treatment and prognosis of this disease. Keywords: Arrhythmia, heart rate variability, dilated cardiomyopathy, elderly

scholarly journals Heart rate turbulence in healthy dogs and dogs with dilated cardiomyopathy

2012 ◽  
Vol 15 (3) ◽  
pp. 469-475 ◽  
Author(s):  
A. Noszczyk-Nowak
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Dilated Cardiomyopathy ◽  
Autonomic Neuropathy ◽  
Regression Line ◽  
Reference Value ◽  
Control Group ◽  
Heart Rate Turbulence ◽  
Percentage Difference ◽  
Healthy Dogs

Abstract Heart rate turbulence (HRT) is modulated by the baroreceptor reflex and it was suggested that it could be used as a measure of autonomic dysfunction. Impaired HRT is of a significant prognostic value in humans after myocardial infarction, suffering from dilated cardiomyopathy and patients with heart failure. So far no studies were performed assessing the importance of HRT in dogs. The aim of this study was to prospectively evaluate the HRT turbulence onset (TO) and the turbulence slope (TS) in healthy dogs and in dogs with DCM and to compare the HRT in dogs with DCM that died during the first 30 days of observation and dogs with DCM that survived the first 30 days after the HRT analysis. The current study was aimed at determining reference value of the TO and TS of HRT in healthy dogs (control group) and dogs with dilated cardiomyopathy (DCM group). The tests were carried out on 30 healthy dogs and 30 dogs with DCM composed of Boxers, Doberman pinschers and Great Danes, of different sexes and body weights from 22 to 72 kg, aged between 1.5 and 11.5 years, submitted to the 24-hour Holter monitoring. HRT parameters were calculated using an HolCard software algorithm. TO is a percentage difference between the heart rate immediately following ventricular premature complex (VPC) and the heart rate immediately preceding VPC. TS corresponds to the steepest slope of the linear regression line for each sequence of five consecutive normal intervals in the local tachogram. The average TO in healthy dogs was determined as -13.55 ± 11.12%, TS was 21.33 ± 9.66 ms/RR. TO in dogs with DCM was determined as - 2.61 ± 2.1% and TS was 6.15 ± 3.86 ms/RR. Parameters of HRT were statistically significantly decreased (p<0.01) in dogs with DCM. HRT TO and TS were statistically significantly decreased in dogs with DCM. Dogs with DCM that survived more than 30 days of observation had HRT statistically significantly decreased in comparison to dogs with DCM that died after the 30’th day of observation. Decreased HRT parameters in dogs with DCM suggest an autonomic neuropathy which principally consists of the withdrawal of the cardiac parasympathetic tone. The more the autonomic neuropathy is advanced the faster the death of the dog with DCM might occur, with no correlation with the level of the heart failure.

scholarly journals Effect of Exercise Training on Heart Rate Variability in Patients with Heart Failure After Percutaneous Coronary Intervention

2018 ◽  
Author(s):  
S Abolahrari-Shirazi ◽  
J Kojuri ◽  
Z Bagheri ◽  
Z Rojhani-Shirazi
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Percutaneous Coronary Intervention ◽  
Exercise Training ◽  
Ejection Fraction ◽  
Coronary Intervention ◽  
Control Group ◽  
Percutaneous Coronary ◽  
Patients With Heart Failure

Background: This study aims to evaluate the effect of exercise training on heart rate variability (HRV) and to determine the correlation between parameters of HRV and the ejection fraction in patients with heart failure after percutaneous coronary intervention.Material and Methods: Fifty patients with left ventricular ejection fraction ≤ 40% undergone percutaneous coronary intervention were randomly allocated in either an exercise training (ET) group or a control group. The ET group performed exercise training for 45 minutes, three times a week for seven weeks. Patients in both groups received a leaflet for daily exercising at home. HRV parameters comprising, the standard deviation of normal R-R intervals (SDNN), the square root of the mean of the squares of successive R-R intervals differences (RMSSD) ,the percentage of successive R-R intervals differing from more than 50 ms (PNN50), using 24-hour Holter electrocardiographic monitoring was measured.Results: After the intervention, the SDNN improved in the ET group (P=0.002), while changes in all remaining HRV indices were insignificant (P≥0.05). The control group showed no significant changes in any HRV parameters (P≥0.05). Changes in SDNN in the ET group were significantly different from the control group (P=0.003). At baseline, our results revealed a significant weak correlation between ejection fraction and SDNN (r =0.279, P=0.047). However, ejection fraction did not correlate significantly with RMSSD and PNN50.Conclusion: Exercise training is safe and feasible in post percutaneous coronary intervention patients, even in those with reduced ejection fraction. In a seven-week period, exercise training was effective in improving HRV in heart failure patients after percutaneous coronary intervention.

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