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Fractal correlation properties of heart rate dynamics and adverse events in patients with implantable cardioverter-defibrillators.

Publication ,  Journal Article
Perkiömäki, JS; Zareba, W; Daubert, JP; Couderc, JP; Corsello, A; Kremer, K
Published in: Am J Cardiol
July 1, 2001

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.

Duke Scholars

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

July 1, 2001

Volume

88

Issue

1

Start / End Page

17 / 22

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Treatment Outcome
  • Statistics, Nonparametric
  • Regression Analysis
  • Proportional Hazards Models
  • Prognosis
  • Predictive Value of Tests
  • Postoperative Complications
  • Middle Aged
  • Male
 

Citation

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Perkiömäki, J. S., Zareba, W., Daubert, J. P., Couderc, J. P., Corsello, A., & Kremer, K. (2001). Fractal correlation properties of heart rate dynamics and adverse events in patients with implantable cardioverter-defibrillators. Am J Cardiol, 88(1), 17–22. https://doi.org/10.1016/s0002-9149(01)01578-8
Perkiömäki, J. S., W. Zareba, J. P. Daubert, J. P. Couderc, A. Corsello, and K. Kremer. “Fractal correlation properties of heart rate dynamics and adverse events in patients with implantable cardioverter-defibrillators.Am J Cardiol 88, no. 1 (July 1, 2001): 17–22. https://doi.org/10.1016/s0002-9149(01)01578-8.
Perkiömäki JS, Zareba W, Daubert JP, Couderc JP, Corsello A, Kremer K. Fractal correlation properties of heart rate dynamics and adverse events in patients with implantable cardioverter-defibrillators. Am J Cardiol. 2001 Jul 1;88(1):17–22.
Perkiömäki, J. S., et al. “Fractal correlation properties of heart rate dynamics and adverse events in patients with implantable cardioverter-defibrillators.Am J Cardiol, vol. 88, no. 1, July 2001, pp. 17–22. Pubmed, doi:10.1016/s0002-9149(01)01578-8.
Perkiömäki JS, Zareba W, Daubert JP, Couderc JP, Corsello A, Kremer K. Fractal correlation properties of heart rate dynamics and adverse events in patients with implantable cardioverter-defibrillators. Am J Cardiol. 2001 Jul 1;88(1):17–22.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

July 1, 2001

Volume

88

Issue

1

Start / End Page

17 / 22

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Treatment Outcome
  • Statistics, Nonparametric
  • Regression Analysis
  • Proportional Hazards Models
  • Prognosis
  • Predictive Value of Tests
  • Postoperative Complications
  • Middle Aged
  • Male