engleski

Different cut-off level of pathological heart rate variability in different groups of cardiac patients

Heart rate variability (HRV) differs by type and stage of the disease, by age, by environment, etc. Criteria for normal, moderately changed and pathological values of HRV lack for routine clinical work with different groups of cardiac patients. Twelve time- and frequency-domain HRV variables were analysed from 24-hour Holter ECG in 2578 consecutive patients of both sexes (57% male) aged 15 to 91 (mean 54&#61617; 13) years. Fifty-nine percent of the patients were out-of-hospital patients, 15% from cardiac unit of internal medicine department and 26% from stationary cardiac rehabilitation. Arrhythmias of aetiology other than coronary artery disease predominate in out-patients and coronary artery disease in in-patients. Limits of moderately and pathologically changed values were determined according to biostatistical principles. HRV differed by age, sex and type of patients (MANOVA p<0.001). Heart rate and all HRV measures have decreased with age. Female had faster heart rate, but more pronounced vagal modulated activity than male. Out-patients had better HRV than in-patients. Cut-off level of pathological standard deviation of normal R-R intervals (measure of overall HRV) ranged from 75 ms in female out-patients to 44 ms in male patients from cardiac internal medicine department. Different cut-points of 12 HRV measures are obtained for 12 subgroups of patients. Following HRV differences between different cardiac patients, different limits of normal and decreased HRV are proposed for daily practice.

reference values; heart rate; autonomic nervous system; cardiovascular diseases

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