This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fauchier, L. Articles by Fauchier, J. P. Search for Related Content PubMed PubMed Citation Articles by Fauchier, L. Articles by Fauchier, J. P.

CLINICAL STUDIES

Prognostic value of heart rate variability for sudden death and major arrhythmic events in patients with idiopathic dilated cardiomyopathy

^a Service de Cardiologie B et Laboratoire d’électrophysiologie cardiaque, Centre Hospitalier Universitaire Trousseau, Tours, France

Manuscript received March 27, 1998; revised manuscript received November 25, 1998, accepted January 5, 1999.

Reprint requests and correspondence: Laurent Fauchier, MD, Service de Cardiologie B., Centre Hospitalier Universitaire Trousseau, 37044 Tours, France
lfau{at}med.univ-tours.fr

OBJECTIVE

This study was designed to evaluate the prognostic value of heart rate variability for sudden death, resuscitated ventricular fibrillation or sustained ventricular tachycardia in patients with idiopathic dilated cardiomyopathy.

BACKGROUND

Previous studies have shown that heart rate variability could predict arrhythmic events and sudden death in postinfarction patients, but the prognostic value of heart rate variability for arrhythmic events or sudden death in patients with idiopathic dilated cardiomyopathy has not been established.

METHODS

Time and frequency domain analysis of heart rate variability on 24-h electrocardiographic (ECG) recording was assessed in 116 patients with idiopathic dilated cardiomyopathy (91 men, aged 51 ± 12 years, left ventricular ejection fraction 34 ± 12%).

RESULTS

Mean follow-up (± SD) was 53 ± 39 months. Sixteen patients reached one of the defined study end-points (sudden death, resuscitated ventricular fibrillation or sustained ventricular tachycardia) during follow-up. Using multivariate analysis, only reduced standard deviation of all normal-to-normal intervals (SDNN) (p = 0.02) and ventricular tachycardia during 24-h ECG recording (p = 0.02) predicted sudden death and/or arrhythmic events. For SDNN, a cutoff level of 100 ms seemed the best for the risk stratification.

CONCLUSIONS

Decrease in heart rate variability is an independent predictor of arrhythmic events and sudden death in idiopathic dilated cardiomyopathy, whether the mechanism of sudden death is ventricular tachyarrhythmia or not.

Abbreviations and Acronyms   CHF = congestive heart failure   ECG = electrocardiogram   HF = high frequency power   HRV = heart rate variability   IDC = idiopathic dilated cardiomyopathy   LF = low frequency power   LV = left ventricle   Mean RR = mean duration of all normal-to-normal   NN = normal-to-normal intervals   NYHA class = New York Heart Association function class   pNN50 = number of NN intervals differing by more than 50 ms from adjacent interval divided by the total number of all NN intervals   rmsSD = square root of the sum of the squares of differences between adjacent NN intervals   SDANN = standard deviation of the averages of NN intervals in all 5-min segments   SDNN = standard deviation of all NN intervals   Tot P = total frequency power   VLF = very low frequency power   VF = ventricular fibrillation   VT = ventricular tachycardia

This article has been cited by other articles:

				H. Mongue-Din, A. Salmon, M. Y. Fiszman, and Y. Fromes Periodic variation in R-R intervals and cardiovascular autonomic regulation in young adult Syrian hamsters Am J Physiol Regulatory Integrative Comp Physiol, March 1, 2009; 296(3): R610 - R617. [Abstract] [Full Text] [PDF]

				P. A. Noseworthy and C. Newton-Cheh Genetic Determinants of Sudden Cardiac Death Circulation, October 28, 2008; 118(18): 1854 - 1863. [Full Text] [PDF]

				C. T. Chan Heart rate variability in patients with end-stage renal disease: an emerging predictive tool for sudden cardiac death? Nephrol. Dial. Transplant., October 1, 2008; 23(10): 3061 - 3062. [Full Text] [PDF]

				H. Schubiner, B. Hassunizadeh, and R. Kaczynski A controlled study of autonomic nervous system function in adults with attention-deficit/hyperactivity disorder treated with stimulant medications: results of a pilot study. J Atten Disord, November 1, 2006; 10(2): 205 - 211. [Abstract] [PDF]

				E Ammendola, V Russo, L Politano, L Santangelo, and R Calabro Is heart rate variability a valid parameter to predict sudden death in patients with Becker's muscular dystrophy? Heart, November 1, 2006; 92(11): 1686 - 1687. [Full Text] [PDF]

				F. Enseleit and F. Duru Long-term continuous external electrocardiographic recording: a review. Europace, April 1, 2006; 8(4): 255 - 266. [Abstract] [Full Text] [PDF]

				J. A. Abbott Heart rate and heart rate variability of healthy cats in home and hospital environments Journal of Feline Medicine and Surgery, June 1, 2005; 7(3): 195 - 202. [Abstract] [Full Text] [PDF]

				H. Abuissa, J. H. O'Keefe Jr, W. Harris, and C. J. Lavie Autonomic Function, Omega-3, and Cardiovascular Risk Chest, April 1, 2005; 127(4): 1088 - 1091. [Full Text] [PDF]

				L. Fauchier, D. Babuty, A. Melin, P. Bonnet, P. Cosnay, and J. P. Fauchier Heart rate variability in severe right or left heart failure: the role of pulmonary hypertension and resistances Eur J Heart Fail, March 1, 2004; 6(2): 181 - 185. [Abstract] [Full Text] [PDF]

				W. Grimm, M. Christ, J. Bach, H.-H. Muller, and B. Maisch Noninvasive Arrhythmia Risk Stratification in Idiopathic Dilated Cardiomyopathy: Results of the Marburg Cardiomyopathy Study Circulation, December 9, 2003; 108(23): 2883 - 2891. [Abstract] [Full Text] [PDF]

				D. S. Lee, L. D. Green, P. P. Liu, P. Dorian, D. M. Newman, F. C. Grant, J. V. Tu, and D. A. Alter Effectiveness of implantable defibrillators for preventing arrhythmic events and death: A Meta-Analysis J. Am. Coll. Cardiol., May 7, 2003; 41(9): 1573 - 1582. [Abstract] [Full Text] [PDF]

				E. G. Livanis, P. Flevari, G. N. Theodorakis, F. Kolokathis, D. Leftheriotis, and D. Th. Kremastinos Effect of biventricular pacing on heart rate variability in patients with chronic heart failure Eur J Heart Fail, March 1, 2003; 5(2): 175 - 178. [Abstract] [Full Text] [PDF]

				T. Yamada, T. Shimonagata, M. Fukunami, K. Kumagai, H. Ogita, A. Hirata, M. Asai, N. Makino, H. Kioka, H. Kusuoka, et al. Comparison of the prognostic value of cardiac iodine-123 metaiodobenzylguanidine imaging and heart rate variability in patients with chronic heart failure: A prospective study J. Am. Coll. Cardiol., January 15, 2003; 41(2): 231 - 238. [Abstract] [Full Text] [PDF]

				L. Fauchier, O. Marie, D. Casset-Senon, D. Babuty, P. Cosnay, and J. P. Fauchier Interventricular and intraventricular dyssynchrony in idiopathic dilated cardiomyopathy: A prognostic study with fourier phase analysis of radionuclide angioscintigraphy J. Am. Coll. Cardiol., December 4, 2002; 40(11): 2022 - 2030. [Abstract] [Full Text] [PDF]

				R. Marchioli, F. Barzi, E. Bomba, C. Chieffo, D. Di Gregorio, R. Di Mascio, M. G. Franzosi, E. Geraci, G. Levantesi, A. P. Maggioni, et al. Early Protection Against Sudden Death by n-3 Polyunsaturated Fatty Acids After Myocardial Infarction: Time-Course Analysis of the Results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione Circulation, April 23, 2002; 105(16): 1897 - 1903. [Abstract] [Full Text] [PDF]

				J.-i. Hayano, S. Mukai, H. Fukuta, S. Sakata, N. Ohte, and G. Kimura Postural Response of Low-Frequency Component of Heart Rate Variability Is an Increased Risk for Mortality in Patients With Coronary Artery Disease Chest, December 1, 2001; 120(6): 1942 - 1952. [Abstract] [Full Text] [PDF]

				S. Miyamoto, M. Fujita, H. Sekiguchi, Y. Okano, N. Nagaya, K. Ueda, S.-i. Tamaki, R. Nohara, S. Eiho, and S. Sasayama Effects of posture on cardiac autonomic nervous activity in patients with congestive heart failure J. Am. Coll. Cardiol., June 1, 2001; 37(7): 1788 - 1793. [Abstract] [Full Text] [PDF]

				R. Marchioli Treatment with n-3 polyunsaturated fatty acids after myocardial infarction: results of GISSI-prevenzione trial Eur. Heart J. Suppl., June 1, 2001; 3(suppl_D): D85 - D97. [Abstract] [PDF]

				D. Babuty and M. J Lab Mechanoelectric contributions to sudden cardiac death Cardiovasc Res, May 1, 2001; 50(2): 270 - 279. [Full Text] [PDF]

				X. Jouven, M. Zureik, M. Desnos, C. Guerot, and P. Ducimetiere Resting heart rate as a predictive risk factor for sudden death in middle-aged men Cardiovasc Res, May 1, 2001; 50(2): 373 - 378. [Abstract] [Full Text] [PDF]

				M. Iwata, T. Yoshikawa, A. Baba, T. Anzai, H. Mitamura, and S. Ogawa Autoantibodies against the second extracellular loop of beta1-adrenergic receptors predict ventricular tachycardia and sudden death in patients with idiopathic dilated cardiomyopathy J. Am. Coll. Cardiol., February 1, 2001; 37(2): 418 - 424. [Abstract] [Full Text] [PDF]

				L. Fauchier, D. Babuty, P Cosnay, and J.P. Fauchier Digoxin and morality in idiopathic dilated cardiomyopathy Eur. Heart J., May 2, 2000; 21(10): 858 - 859. [PDF]

				L. Fauchier Reply J. Am. Coll. Cardiol., April 1, 2000; 35(5): 1363 - 1363. [Full Text] [PDF]

				B. Eryonucu, M. Bilge, and N. Guler Prognostic value of heart rate variability in idiopathic dilated cardiomyopathy J. Am. Coll. Cardiol., April 1, 2000; 35(5): 1363 - 1363. [Full Text] [PDF]

				P. K. Stein Sudden death, arrhythmic events and measurements of heart rate variability J. Am. Coll. Cardiol., December 1, 1999; 34(7): 2148 - 2148. [Full Text] [PDF]

				L. Fauchier and D. Babuty Reply J. Am. Coll. Cardiol., December 1, 1999; 34(7): 2148 - 2149. [Full Text] [PDF]