PMID- 11423052
OWN - NLM
STAT- MEDLINE
DCOM- 20010726
LR  - 20190622
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 88
IP  - 1
DP  - 2001 Jul 1
TI  - Fractal correlation properties of heart rate dynamics and adverse events in 
      patients with implantable cardioverter-defibrillators.
PG  - 17-22
AB  - The aim of this study was to determine the prognostic significance of nonlinear 
      and standard heart rate (HR) variability parameters in predicting future adverse 
      events (AEs) in patients with implantable cardioverter-defibrillators. In 
      postinfarction studies, nonlinear measures of HR variability obtained from 
      long-term electrocardiographic recordings have been suggested to be better 
      predictors of adverse outcomes than conventional HR variability measures. 
      Fifty-five high-risk patients with reduced left ventricular function and an 
      implantable cardioverter-defibrillator had a 10-minute, high-resolution 
      electrocardiographic recording after which they were followed for 25 months on 
      average. Implantable cardioverter-defibrillator shock or death was determined as 
      the end point. The SD of all normal-to-normal RR intervals, the square root of 
      the mean squared differences of successive normal-to-normal RR intervals, and the 
      proportion of interval differences of successive normal-to-normal RR intervals 
      >50 ms, low-frequency and high-frequency powers of the power spectrum and their 
      ratio were calculated as conventional measures of HR variability. The short-term 
      scaling exponent (alpha(1)) and approximate entropy were determined as nonlinear 
      measures of HR variability. AEs occurred in 23 patients (42%). Patients with AEs 
      had significantly lower alpha(1) than event-free patients: 0.81 +/- 0.29 (mean 
      +/- SD) versus 1.01 +/- 0.30 (p = 0.02). None of the other HR variability 
      parameters differed significantly between patients with and without AEs. In the 
      Cox proportional-hazards model including age, gender, ejection fraction, 
      occurrence of ventricular tachyarrhythmia before defibrillator implantation, 
      beta-blocker usage, and alpha(1), only alpha(1) was an independent predictor of 
      AEs: hazard ratio 1.20 (95% confidence interval 1.03 to 1.39) for every 0.10 
      decrease in alpha(1) (p = 0.020). In conclusion, alpha(1) obtained from a 
      10-minute electrocardiographic recording yields important prognostic information 
      about the risk of AEs in patients with implantable cardioverter-defibrillators.
FAU - Perkiomaki, J S
AU  - Perkiomaki JS
AD  - Cardiology Unit, Department of Medicine, University of Rochester School of 
      Medicine and Dentistry, Rochester, New York 14642, USA.
FAU - Zareba, W
AU  - Zareba W
FAU - Daubert, J P
AU  - Daubert JP
FAU - Couderc, J P
AU  - Couderc JP
FAU - Corsello, A
AU  - Corsello A
FAU - Kremer, K
AU  - Kremer K
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Aged
MH  - *Defibrillators, Implantable
MH  - *Electrocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Fractals
MH  - Heart Rate/*physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Postoperative Complications/epidemiology
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Regression Analysis
MH  - Statistics, Nonparametric
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/mortality/*physiopathology/therapy
EDAT- 2001/06/26 10:00
MHDA- 2001/07/28 10:01
CRDT- 2001/06/26 10:00
PHST- 2001/06/26 10:00 [pubmed]
PHST- 2001/07/28 10:01 [medline]
PHST- 2001/06/26 10:00 [entrez]
AID - S0002-9149(01)01578-8 [pii]
AID - 10.1016/s0002-9149(01)01578-8 [doi]
PST - ppublish
SO  - Am J Cardiol. 2001 Jul 1;88(1):17-22. doi: 10.1016/s0002-9149(01)01578-8.