Heart rate variability in patients with ventricular arrhythmias: effect of antiarrhythmic drugs. Antiarrhythmic Drug Evaluation Group (ADEG)

Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.

The purpose of this study was to investigate whether heart rate variability could be reliably assessed in patients with ventricular arrhythmias and to evaluate whether it is affected by antiarrhythmic drugs. The study was based on an analysis of 239 ambulatory electrocardiographic (ECG) recordings obtained from 67 patients with frequent and complex ventricular arrhythmias enrolled in the Antiarrhythmic Drug Evaluation Group (ADEG) study. In each recording, after exclusion of premature ventricular complexes, the number of times during a 24 h period in which two consecutive sinus RR intervals differed by more than 50 ms was calculated. The total 24 h count from each recording was then used as an index of heart rate variability. This method is a reliable marker of cardiac parasympathetic activity. Recordings were analyzed at baseline (n = 56), during long-term treatment with amiodarone (n = 17), flecainide (n = 22) or propafenone (n = 17) and after washout in selected patients (n = 5). Despite the presence of a different number of arrhythmias, total 24 h counts in the same patient appeared reproducible over time (r = 0.83 between two different recordings, n = 49, p less than 0.0001). Baseline counts (median 1,698, range 26 to 13,648) were not correlated (r = 0.15) with the number of arrhythmias. The three antiarrhythmic drugs had a disparate effect on total 24 h counts: no change was observed in patients treated with amiodarone (median percent change [delta %]-8, p = NS), whereas a significant (p less than 0.025) decrease occurred in patients treated with flecainide (median delta % -56%) or propafenone (median delta % -64%).(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				J Hoffmann, W Grimm, V Menz, H-H Müller, and B Maisch Heart rate variability and baroreflex sensitivity in idiopathic dilated cardiomyopathy Heart, May 1, 2000; 83(5): 531 - 538. [Abstract] [Full Text]

				A. Stahle, R. Nordlander, and L. Bergfeldt Aerobic group training improves exercise capacity and heart rate variability in elderly patients with a recent coronary event. A randomized controlled study Eur. Heart J., November 2, 1999; 20(22): 1638 - 1646. [Abstract] [PDF]

				M. H. Crawford, S. J. Bernstein, P. C. Deedwania, J. P. DiMarco, K. J. Ferrick, A. Garson Jr, L. A. Green, H. L. Greene, M. J. Silka, P. H. Stone, et al. ACC/AHA guidelines for ambulatory electrocardiography: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the Guidelines for Ambulatory Electrocardiography) developed in collaboration with the North American Society for Pacing and Electrophysiology J. Am. Coll. Cardiol., September 1, 1999; 34(3): 912 - 948. [Full Text] [PDF]

				B Brembilla-Perrot, P Houriez, O Claudon, J-P Preiss, and D Beurrier Predicting the effect of D,L-sotalol on ventricular tachycardia inducibility from the RR variability response Heart, September 1, 1999; 82(3): 307 - 311. [Abstract] [Full Text] [PDF]

				X.-J. Du, H. S. Cox, A. M. Dart, and M. D. Esler Sympathetic activation triggers ventricular arrhythmias in rat heart with chronic infarction and failure Cardiovasc Res, September 1, 1999; 43(4): 919 - 929. [Abstract] [Full Text] [PDF]

				F. Weber, H. Schneider, T. von Arnim, and W. Urbaszek Heart rate variability and ischaemia in patients with coronary heart disease and stable angina pectoris: Influence of drug therapy and prognostic value Eur. Heart J., January 1, 1999; 20(1): 38 - 50. [Abstract] [PDF]

				N. Singh, D. Mironov, P. W. Armstrong, A. M. Ross, and A. Langer Heart Rate Variability Assessment Early After Acute Myocardial Infarction : Pathophysiological and Prognostic Correlates Circulation, April 1, 1996; 93(7): 1388 - 1395. [Abstract] [Full Text]

				T. F. o. t. E. S. o. C. t. N. A. S. o. P. Electrophysiology Heart Rate Variability : Standards of Measurement, Physiological Interpretation, and Clinical Use Circulation, March 1, 1996; 93(5): 1043 - 1065. [Full Text]

				D. G. Zarembski, P. E. Nolan Jr, M. K. Slack, and A. C. Caruso Empiric Long-term Amiodarone Prophylaxis Following Myocardial Infarction: A Meta-Analysis Arch Intern Med, December 13, 1993; 153(23): 2661 - 2667. [Abstract] [PDF]