Document Detail

Heart rate turbulence: a new predictor for risk of sudden cardiac death.
MedLine Citation:
PMID:  15649245     Owner:  NLM     Status:  MEDLINE    
Initial acceleration and a subsequent deceleration of sinus rhythm following a ventricular ectopic beat with a compensatory pause has been termed heart rate turbulence (HRT). The changes in sinus rhythm are thought to be mediated by a baroreflex response to the lower stroke volume of the ectopic beat. HRT is vagally mediated and abolished by atropine, whereas beta-blockers have no effect. HRT has been shown to be an independent and powerful predictor of mortality after myocardial infarction. In patients on beta-blockers, it scores better than left ventricular ejection fraction (LVEF) in its predictive value. Two common measures of HRT are turbulence onset and turbulence slope. When both these measures are abnormal, it is as powerful a predictor of mortality as LVEF. HRT correlates with other indices of cardiac autonomic functions like baroreflex sensitivity and heart rate variability. A composite autonomic index including all these three has been shown to be a powerful predictor of mortality. In patients undergoing direct percutaneous intervention for myocardial infarction, HRT improves in those attaining successful reperfusion. Abnormal values for HRT have been noted in patients with dilated cardiomyopathy and Chagas disease. Diabetic and elderly individuals are more likely to have blunted HRT. HRT cannot be measured in patients lacking ventricular ectopic beats and in patients presenting with atrial fibrillation.
Johnson Francis; Mari A Watanabe; Georg Schmidt
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc     Volume:  10     ISSN:  1082-720X     ISO Abbreviation:  Ann Noninvasive Electrocardiol     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-14     Completed Date:  2005-05-03     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  9607443     Medline TA:  Ann Noninvasive Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  102-9     Citation Subset:  IM    
Medical College Calicut, Kerala, India.
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MeSH Terms
Arrhythmias, Cardiac / physiopathology*
Autonomic Nervous System / physiology
Death, Sudden, Cardiac*
Electrocardiography, Ambulatory*
Heart Conduction System / physiopathology*
Heart Rate / physiology*
Predictive Value of Tests

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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