Original ArticlesPrognostic role of heart rate variability in patients with a recent acute myocardial infarction
Section snippets
Patients
Consecutive patients admitted to our coronary care unit because of acute MI and who underwent Holter monitoring before hospital discharge were eligible for the study. Acute MI was diagnosed according to typical prolonged chest pain (>30 minutes) with significant ST segment and/or T-wave changes, followed by typical elevation of total creatine kinase and its MB isoform, with (Q-wave MI) or without (non–Q-wave MI) the subsequent appearance of diagnostic Q waves on the standard electrocardiogram.
General findings
The main clinical characteristics of patients are summarized in Table I. Mean age of patients was 61±11 years and 82% of them were men. Left ventricular ejection fraction was obtained in 225 patients (94%) and was <40% in 43 (19%), whereas it was not available in 14 patients (6%) because of technical or logistic reasons. Ventricular premature beats ≥10/hour were found in 21% of patients and episodes of nonsustained ventricular tachycardia in 14%. There were 26 total deaths (11%) in a follow-up
Discussion
To the best of our knowledge, this is the first study that simultaneously assessed the predictive value of the most common HRVs in the same population of patients surviving an acute MI. Our results show that some time domain and frequency domain variables may be equally useful in predicting total and cardiac mortality. In contrast with previous studies, however, HRV was not a significant determinant of outcome in our patients, after correction for the most classic prognostic variables (mainly
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