title: Heart rate turbulence following ventricular premature beats in healthy controls.
abstract: BACKGROUND
  Heart rate turbulence (HRT) has recently been described as a strong, independent risk stratifier in postinfarct patients. To date, however, the incidence of false positive HRT findings in adults is unknown. Therefore, we performed a blinded, retrospective analysis of HRT in a prospectively collected database of 110 apparently healthy persons to determine the prevalence and clinical significance of abnormal HRT findings in healthy controls using previously published cut-off values.
  
  
  RESULTS
  The study included 43 out of 110 apparently healthy adults, in whom a sufficient number of ventricular premature beats were available for HRT analysis on 24-hour Holter recordings. The HRT slope was dichotomized at 2.5 ms per R-R interval and HRT onset was dichotomized at 0% using previously established criteria to define an abnormal HRT analysis in postinfarct patients. Using these definitions, abnormal HRT results were found in 2 out of 43 controls (5%) for HRT slope and in 8 out of 43 controls (19%) for HRT onset without any cardiac deaths during 32 +/- 15 months follow-up.
  
  
  CONCLUSIONS
  The incidence of false positive HRT results in healthy middle-aged volunteers is low for HRT slope (5%), but not for HRT onset (19%) when previously published cut-off values are used to define abnormal HRT results. Thus, HRT slope dichotomized at 2.5 ms per R-R interval, but not HRT onset dichotomized at 0%, may be used as a relatively specific tool for risk stratification in middle-aged persons.
authors.affiliation: Department of Cardiology, Munich University of Technology, Germany. Wolfram.Grimm@med.uni-marburg.de
authors.forename: Wolfram
authors.initials: W
authors.lastname: Grimm
authors.forename: Julia
authors.initials: J
authors.lastname: Sharkova
authors.forename: Michael
authors.initials: M
authors.lastname: Christ
authors.forename: Raphael
authors.initials: R
authors.lastname: Schneider
authors.forename: Georg
authors.initials: G
authors.lastname: Schmidt
authors.forename: Bernhard
authors.initials: B
authors.lastname: Maisch
mesh_terms: D000328:Adult; D000368:Aged; D005117:Cardiac Complexes, Premature / Q000503:physiopathology*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment