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Year : 2000  |  Volume : 1  |  Issue : 8  |  Page : 291-300

Heart rate variability following myocardial infarction: Prognostic panacea or enigma?

1 Istituto Medico Chirurgico di Cardiologia, Cattedra di Cardiologia, Seconda Universita'degli Studi di Napoli, Italy
2 University Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom

Correspondence Address:
Gianluca Di Micco
Istituto Medico Chirurgico di Cardiologia, Cattedra di Cardiologia, Seconda Università degli studi di Napoli, Piazza Luigi Miraglia, 80138-Napoli
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Source of Support: None, Conflict of Interest: None

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In normal individuals, heart rate in sinus rhythm varies widely in the course of a 24-hour period, chiefly under the control of the autonomic nervous system. These fluctuations in heart rate can be quantified and the results are referred to as measures of “heart rate variability” (HRV). Time and frequency domain measures of HRV reflect the balance between cardiac sympathetic and para-sympathetic tone during the recording period. This article begins by reviewing the methods and problems of measuring heart rate variability. Impaired HRV is seen in patients following myocardial infarction and is a marker of adverse prognosis, especially of major arrhythmic complications. Acute myocardial infarction affects measurements of HRV. We discuss what can be deduced from abnormally low measures of HRV after infarction. Whether impaired HRV is causally related to arrhythmias or merely an epiphenomenon is then reviewed. The article shows the possible role of heart rate variability as a means of risk stratifying patients after infarction and how the technique could be combined with other tests to optimize risk prediction.

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