J Clin Monit Comput - Heart rate turbulence for guiding electric therapy in patients with cardiac failure.


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CKGROUND: It is well-known that a reduction of the cardiac frequency variability, measurable with the Heart Rate Variability (HRV) system, is an indirect expression of the sympathetic-autonomic tone. Another index, Heart Rate Turbulence (HRT), has been recently suggested as a possible unit of measurement for the sympathetic-autonomic tone: this system allows to estimate the baro-reflex response of the carotid arteries to an early ventricular extra-systole by analysing heart rate variations induced by a premature beat.METHODS AND RESULTS: In our research we have analyzed this phenomenon in patients affected by moderate or severe cardiac failure. In particular, we divided 110 patients into two arms: subjects with or without a history of resuscitated arrhythmic death, that is, patients with high or low arrhythmic potential. In a detailed analysis of the sympathetic-autonomic tone, using both the above-mentioned parameters, HRV showed an irrelevant statistical difference between the two arms; on the contrary, HRT showed a significant statistical difference.CONCLUSIONS: If our conclusions will be confirmed by next larger reports, HRT could become a reliable index for screening the arrhythmic potential of patients affected by cardiac failure, to select the ones who need a defibrillator implantation.

Resumo Limpo

ckground wellknown reduct cardiac frequenc variabl measur heart rate variabl hrv system indirect express sympatheticautonom tone anoth index heart rate turbul hrt recent suggest possibl unit measur sympatheticautonom tone system allow estim baroreflex respons carotid arteri earli ventricular extrasystol analys heart rate variat induc prematur beatmethod result research analyz phenomenon patient affect moder sever cardiac failur particular divid patient two arm subject without histori resuscit arrhythm death patient high low arrhythm potenti detail analysi sympatheticautonom tone use abovement paramet hrv show irrelev statist differ two arm contrari hrt show signific statist differenceconclus conclus will confirm next larger report hrt becom reliabl index screen arrhythm potenti patient affect cardiac failur select one need defibril implant

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