Continuous Autonomic Assessment in Patients With Symptomatic Heart Failure

DOI Web Site 被引用文献11件
  • Philip B. Adamson
    From the Department of Medicine (P.B.A.), Cardiovascular Disease and Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Okla; the Carlyle Fraser Heart Center/Division of Cardiology (A.L.S.), Emory University School of Medicine, Atlanta, Ga; Ohio State University Heart Center (W.T.A.), Columbus, Ohio; and Medtronic, Inc (K.J.K., R.W.S., A.S., M.M.R.), Minneapolis, Minn.
  • Andrew L. Smith
    From the Department of Medicine (P.B.A.), Cardiovascular Disease and Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Okla; the Carlyle Fraser Heart Center/Division of Cardiology (A.L.S.), Emory University School of Medicine, Atlanta, Ga; Ohio State University Heart Center (W.T.A.), Columbus, Ohio; and Medtronic, Inc (K.J.K., R.W.S., A.S., M.M.R.), Minneapolis, Minn.
  • William T. Abraham
    From the Department of Medicine (P.B.A.), Cardiovascular Disease and Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Okla; the Carlyle Fraser Heart Center/Division of Cardiology (A.L.S.), Emory University School of Medicine, Atlanta, Ga; Ohio State University Heart Center (W.T.A.), Columbus, Ohio; and Medtronic, Inc (K.J.K., R.W.S., A.S., M.M.R.), Minneapolis, Minn.
  • Karen J. Kleckner
    From the Department of Medicine (P.B.A.), Cardiovascular Disease and Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Okla; the Carlyle Fraser Heart Center/Division of Cardiology (A.L.S.), Emory University School of Medicine, Atlanta, Ga; Ohio State University Heart Center (W.T.A.), Columbus, Ohio; and Medtronic, Inc (K.J.K., R.W.S., A.S., M.M.R.), Minneapolis, Minn.
  • Robert W. Stadler
    From the Department of Medicine (P.B.A.), Cardiovascular Disease and Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Okla; the Carlyle Fraser Heart Center/Division of Cardiology (A.L.S.), Emory University School of Medicine, Atlanta, Ga; Ohio State University Heart Center (W.T.A.), Columbus, Ohio; and Medtronic, Inc (K.J.K., R.W.S., A.S., M.M.R.), Minneapolis, Minn.
  • Alex Shih
    From the Department of Medicine (P.B.A.), Cardiovascular Disease and Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Okla; the Carlyle Fraser Heart Center/Division of Cardiology (A.L.S.), Emory University School of Medicine, Atlanta, Ga; Ohio State University Heart Center (W.T.A.), Columbus, Ohio; and Medtronic, Inc (K.J.K., R.W.S., A.S., M.M.R.), Minneapolis, Minn.
  • Melissa M. Rhodes
    From the Department of Medicine (P.B.A.), Cardiovascular Disease and Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Okla; the Carlyle Fraser Heart Center/Division of Cardiology (A.L.S.), Emory University School of Medicine, Atlanta, Ga; Ohio State University Heart Center (W.T.A.), Columbus, Ohio; and Medtronic, Inc (K.J.K., R.W.S., A.S., M.M.R.), Minneapolis, Minn.

書誌事項

タイトル別名
  • Prognostic Value of Heart Rate Variability Measured by an Implanted Cardiac Resynchronization Device

抄録

<jats:p> <jats:bold> <jats:italic>Background—</jats:italic> </jats:bold> Heart rate variability (HRV) as an indirect autonomic assessment provides prognostic information when measured over short time periods in patients with heart failure. Long-term continuous HRV can be measured from an implantable device, but the clinical value of these measurements is unknown. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods and Results—</jats:italic> </jats:bold> A total of 397 patients with New York Heart Association class III or IV heart failure were studied. Of these, 370 patients had information from their implanted cardiac resynchronization device for mortality risk stratification, and 288 patients had information for measured parameters (ie, HRV, night heart rate, and patient activity) and clinical event analyses. Continuous HRV was measured as the standard deviation of 5-minute median atrial-atrial intervals (SDAAM) sensed by the device. SDAAM <50 ms when averaged over 4 weeks was associated with increased mortality risk (hazard ratio 3.20, <jats:italic>P</jats:italic> =0.02) and SDAAM were persistently lower over the entire follow-up period in patients who required hospitalization or died. SDAAM decreased a median of 16 days before hospitalization and returned to baseline after treatment. Automated detection of decreases in SDAAM was 70% sensitive in detecting cardiovascular hospitalization, with 2.4 false-positives per patient-year of follow-up. </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusions—</jats:italic> </jats:bold> This study demonstrates that SDAAM continuously measured from an implanted cardiac resynchronization device is lower in patients at high mortality and hospitalization risk. SDAAM declines as patient status decompensates. Continuous long-term SDAAM may be a useful tool in the clinical management of patients with chronic heart failure. </jats:p>

収録刊行物

  • Circulation

    Circulation 110 (16), 2389-2394, 2004-10-19

    Ovid Technologies (Wolters Kluwer Health)

被引用文献 (11)*注記

もっと見る

キーワード

詳細情報 詳細情報について

問題の指摘

ページトップへ