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Heart Rate Variability Triangular Index as a Predictor of Cardiovascular Mortality in Patients With Atrial Fibrillation

Hämmerle, Peter and Eick, Christian and Blum, Steffen and Schlageter, Vincent and Bauer, Axel and Rizas, Konstantinos D. and Eken, Ceylan and Coslovsky, Michael and Aeschbacher, Stefanie and Krisai, Philipp and Meyre, Pascal and Vesin, Jean-Marc and Rodondi, Nicolas and Moutzouri, Elisavet and Beer, Jürg and Moschovitis, Giorgio and Kobza, Richard and Di Valentino, Marcello and Corino, Valentina D. A. and Laureanti, Rita and Mainardi, Luca and Bonati, Leo H. and Sticherling, Christian and Conen, David and Osswald, Stefan and Kühne, Michael and Zuern, Christine S. and Swiss‐AF Study Investigators, . (2020) Heart Rate Variability Triangular Index as a Predictor of Cardiovascular Mortality in Patients With Atrial Fibrillation. Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease, 9 (15). e016075.

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Abstract

Background Impaired heart rate variability (HRV) is associated with increased mortality in sinus rhythm. However, HRV has not been systematically assessed in patients with atrial fibrillation (AF). We hypothesized that parameters of HRV may be predictive of cardiovascular death in patients with AF. Methods and Results From the multicenter prospective Swiss-AF (Swiss Atrial Fibrillation) Cohort Study, we enrolled 1922 patients who were in sinus rhythm or AF. Resting ECG recordings of 5-minute duration were obtained at baseline. Standard parameters of HRV (HRV triangular index, SD of the normal-to-normal intervals, square root of the mean squared differences of successive normal-to-normal intervals and mean heart rate) were calculated. During follow-up, an end point committee adjudicated each cause of death. During a mean follow-up time of 2.6±1.0 years, 143 (7.4%) patients died; 92 deaths were attributable to cardiovascular reasons. In a Cox regression model including multiple covariates (age, sex, body mass index, smoking status, history of diabetes mellitus, history of hypertension, history of stroke/transient ischemic attack, history of myocardial infarction, antiarrhythmic drugs including β blockers, oral anticoagulation), a decreased HRV index ≤ median (14.29), but not other HRV parameters, was associated with an increase in the risk of cardiovascular death (hazard ratio, 1.7; 95% CI, 1.1-2.6;; P; =0.01) and all-cause death (hazard ratio, 1.42; 95% CI, 1.02-1.98;; P; =0.04). Conclusions The HRV index measured in a single 5-minute ECG recording in a cohort of patients with AF is an independent predictor of cardiovascular mortality. HRV analysis in patients with AF might be a valuable tool for further risk stratification to guide patient management. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02105844.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Kardiologie > Klinische Outcomeforschung Kardiologie (Müller)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Kardiologie > Klinische Outcomeforschung Kardiologie (Müller)
UniBasel Contributors:Hämmerle, Peter and Blum, Steffen and Eken, Ceylan and Coslovsky, Michael and Aeschbacher, Stefanie and Krisai, Philipp and Braun-Meyre, Pascal and Sticherling, Christian and Conen, David and Osswald, Stefan and Meyer-Zürn, Christine and Kühne, Michael
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:American Heart Association
e-ISSN:2047-9980
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:16 Mar 2022 15:02
Deposited On:16 Mar 2022 15:02

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