Heart rate turbulence for guiding electric therapy in patients with cardiac failure.
BACKGROUND
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.


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.
Fazio
Giovanni
G
Department of Cardiology, University of Palermo, Via Albiri 3 a, 90125, Palermo, Italy. Giovanni.fazio-aaaa@poste.it
Sarullo
Filippo M
FM
D'Angelo
Luciana
L
Lunetta
Monica
M
Visconti
Claudia
C
Di Gesaro
Gabriele
G
Sutera
Loredana
L
Novo
Giuseppina
G
Novo
Salvatore
S
D000465:Algorithms; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology* / Q000517:prevention & control; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004554:Electric Countershock / Q000379:methods*; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology* / Q000517:prevention & control; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013813:Therapy, Computer-Assisted / Q000379:methods