Patterns of beat-to-beat heart rate variability in advanced heart failure

doi:10.1016/0002-8703(92)90510-3

American Heart Journal

Volume 123, Issue 3, March 1992, Pages 704-710

https://doi.org/10.1016/0002-8703(92)90510-3 Get rights and content

Abstract

Diminished heart rate variability is associated with high sympathetic tone and an increased mortality rate in heart failure cases. We constructed Poincaré plots of each sinus R-R interval plotted against the subsequent R-R interval from 24-hour Holter recordings of 24 healthy subjects (control group) and 24 patients with heart failure. Every subject in the control group had a comet-shaped Poincaré plot resulting from an increase in beat-to-beat dispersion as heart rate slowed. No patient with heart failure had this comet-shaped pattern. Instead, three distinctive patterns were identified: (1) a torpedo-shaped pattern resulting from low R-R interval dispersion over the entire range of heart rates, (2) a fanshaped pattern resulting from restriction of overall R-R interval ranges with enhanced dispersion, and (3) complex patterns with clusters of points characteristic of stepwise changes in R-R intervals. Poincaré pattern could not be predicted from standard deviations of R-R intervals. This first use of Poincaré plots in heart rate variability analysis reveals a complexity not readily perceived from standard deviation information. Further study is warranted to determine if this method will allow refined assessment of cardiac-autonomic integrity in heart failure, which could help identify patients at highest risk for sudden death.

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Citation Excerpt :
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^☆: Supported in part by a grant from the Gamma Tau Chapter of Sigma Theta Tan and by the Audrienne H. Moseley Scholar Award, UCLA School of Nursing.

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Patterns of beat-to-beat heart rate variability in advanced heart failure☆

Abstract

Am J Cardiol

Am J Cardiol

Am J Cardiol

Am J Cardiol

Am J Cardiol

Am Heart J

Am Heart J

Physica

Am J Cardiol

Am J Cardiol

Sinus arrhythmia in acute myocardial infarction

Med J Aust

Assessment of methods for estimating autonomic nervous control of the heart in patients with diabetes mellitus

Diabetes