An easy-to-use technique to characterize cardiodynamics from first-return maps on ΔRR-intervals.
Heart rate variability analysis using 24-h Holter monitoring is frequently performed to assess the cardiovascular status of a patient. The present retrospective study is based on the beat-to-beat interval variations or ΔRR, which offer a better view of the underlying structures governing the cardiodynamics than the common RR-intervals. By investigating data for three groups of adults (with normal sinus rhythm, congestive heart failure, and atrial fibrillation, respectively), we showed that the first-return maps built on ΔRR can be classified according to three structures: (i) a moderate central disk, (ii) a reduced central disk with well-defined segments, and (iii) a large triangular shape. These three very different structures can be distinguished by computing a Shannon entropy based on a symbolic dynamics and an asymmetry coefficient, here introduced to quantify the balance between accelerations and decelerations in the cardiac rhythm. The probability P111111 of successive heart beats without large beat-to-beat fluctuations allows to assess the regularity of the cardiodynamics. A characteristic time scale, corresponding to the partition inducing the largest Shannon entropy, was also introduced to quantify the ability of the heart to modulate its rhythm: it was significantly different for the three structures of first-return maps. A blind validation was performed to validate the technique.
CORIA UMR 6614-Normandie Université, CNRS et INSA de Rouen, Campus Universitaire du Madrillet, F-76800 Saint-Etienne du Rouvray, France.
Emeline
E
Fresnel
CORIA UMR 6614-Normandie Université, CNRS et INSA de Rouen, Campus Universitaire du Madrillet, F-76800 Saint-Etienne du Rouvray, France.
Emad
E
Yacoub
ADIR Association, Hôpital de Bois-Guillaume, F-76031 Rouen, France.
Ubiratan
U
Freitas
CORIA UMR 6614-Normandie Université, CNRS et INSA de Rouen, Campus Universitaire du Madrillet, F-76800 Saint-Etienne du Rouvray, France.
Adrien
A
Kerfourn
CORIA UMR 6614-Normandie Université, CNRS et INSA de Rouen, Campus Universitaire du Madrillet, F-76800 Saint-Etienne du Rouvray, France.
Valérie
V
Messager
Service de pédiatrie médicale, CIC INSERM 204, CHU Charles Nicolle, F-76031 Rouen, France.
Eric
E
Mallet
GRHV/EA 3830, CHU Charles Nicolle, F-76031 Rouen, France.
Jean-François
JF
Muir
CORIA UMR 6614-Normandie Université, CNRS et INSA de Rouen, Campus Universitaire du Madrillet, F-76800 Saint-Etienne du Rouvray, France.
Christophe
C
Letellier
D000328:Adult; D019992:Databases as Topic; D004562:Electrocardiography / Q000379:methods*; D019277:Entropy; D006321:Heart / Q000502:physiology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D015203:Reproducibility of Results