title: Association of heart rate variability with arrhythmic events in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia.
abstract: BACKGROUND
  Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is associated with an increased risk of sudden cardiac death (SCD). Risk stratification of ARVC/D patients, however, remains an unresolved issue. In this study we investigated whether heart rate variability (HRV) can be helpful in identifying ARVC/D patients with increased risk of arrhythmic events.
  
  
  RESULTS
  We studied 30 consecutive patients (17 males; 45.4 ± 18 years) with ARVC/D, diagnosed according to guideline criteria; 15 patients (50%) had received an implantable cardioverter defibrillator (ICD) for primary SCD prevention. HRV was assessed on 24-h ECG Holter monitoring. The primary endpoint was the occurrence of major arrhythmic events (SCD, sustained ventricular tachycardia (VT), ICD therapy for sustained VT or ventricular fibrillation (VF)). During the follow-up period (19 ± 7 months), no deaths occurred, but 5 patients (17%) experienced arrhythmic events (4 VTs and 1 VF, all in the ICD group). All HRV parameters were significantly lower in patients with, compared with those without, arrhythmic events. Low-frequency amplitude was the most significant HRV variable associated with arrhythmic events in univariate Cox regression analysis (P=0.017), and was the only significant predictor of arrhythmic events in multivariable regression analysis (hazard ratio 0.88, P=0.047), together with unexplained syncope (hazard ratio 16.1, P=0.039).
  
  
  CONCLUSIONS
  Our data show that among ARVC/D patients HRV analysis might be helpful in identifying those with increased risk of major arrhythmic events.
authors.affiliation: Department of Cardiovascular Medicine, Cardiology Center, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Irma
authors.initials: I
authors.lastname: Battipaglia
authors.forename: Giancarla
authors.initials: G
authors.lastname: Scalone
authors.forename: Andrea
authors.initials: A
authors.lastname: Macchione
authors.forename: Gaetano
authors.initials: G
authors.lastname: Pinnacchio
authors.forename: Marianna
authors.initials: M
authors.lastname: Laurito
authors.forename: Maria
authors.initials: M
authors.lastname: Milo
authors.forename: Gemma
authors.initials: G
authors.lastname: Pelargonio
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Bencardino
authors.forename: Fulvio
authors.initials: F
authors.lastname: Bellocci
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pieroni
authors.forename: Gaetano A
authors.initials: GA
authors.lastname: Lanza
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications*; D004198:Disease Susceptibility; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests