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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Annals of noninvasive electrocardiology 7 (2002), S. 0 
    ISSN: 1542-474X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Measurement of short-term fractal-like correlation properties of heart rate dynamics has been shown to be a useful prognostic indicator of adverse events in cardiac patients. Complexity measurements of heart rate variability (HRV) have already provided important information in many cardiac conditions. However, data on the physiological background of these newer nonlinear measures of HRV are limited.Methods: Nine healthy subjects (aged from 22 to 35 years, 6 males, 3 females) had an electro-cardiographic (ECG) recording during controlled breathing in supine position. HRV was analyzed for 5 min periods before and after intravenous injection of 0.6 mg of atropine using conventional HRV measures and newer nonlinear HRV measures including the short-term scaling exponent (a,) and approximate entropy (ApEn).Results: The short-term scaling exponent a1 increased significantly after atropine injection (1.01 ± 0.23 vs 1.43 ± 0.19, P = 0.001). There was no significant difference between ApEn values before and after atropine injection (0.87 ± 0.17 vs 0.70 ± 0.31, respectively, P = 0.27). At baseline before atropine administration, a1 had a significant negative correlation with SDNN, RMSSD, and HF (r = -0.70, -0.76, -0.67, respectively, P 〈0.05 for all), and a significant positive correlation with heart rate (r = 0.76, P 〈 0.05). After atropine injection, a, did not have significant correlation with any of the HRV parameters or heart rate. There were no significant correlations between ApEn and any of the HRV measures or heart rate either before or after atropine administration.Conclusions: Vagal tone has an important influence on the values of the short-term scaling exponent a,. However, vagal modulation is not a major determinant of the values of ApEn. A.N.E. 2002;7(4):326–331
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Futura Publishing, Inc.
    Pacing and clinical electrophysiology 26 (2003), S. 0 
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Increased repolarization variability has been observed in various cardiac conditions. However, data on its relation to heart rate variability and on its value in predicting adverse outcomes in high risk patients are limited. Forty-seven patients with decreased left ventricular function and ICDs had high resolution 10-minute ECG recordings and were followed for 781 ± 258 days (mean ± SD) on average. The interval from the R peak to the T wave peak with maximum amplitude (RTmax) and from the R peak to the T wave offset (RToff) were determined automatically on a beat-to-beat basis. Temporal beat-to-beat RTmax and RToff variability were analyzed using traditional summary statistics, a complexity measure (approximate entropy [ApEn]), and the short-term scaling exponent (α1). Eight (17%) patients died and 16 (34%) patients experienced death/appropriate ICD shock during follow-up. RTmax-ApEn was significantly higher in patients who died compared with patients who survived (1.24 ± 0.13vs1.01 ± 0.21, respectively, P = 0.008). When RTmax-ApEn was tested together with the α1 of the RR intervals, occurrence of ventricular arrhythmias before ICD implantation, and β-blockers usage in the Cox regression analysis, it still independently predicted mortality; hazard ratio = 3.36 (1.28–8.83, 95% CI, P = 0.014) for every 0.10-increase in RTmax-ApEn. None of the repolarization variability parameters independently predicted death/appropriate ICD shocks. Increased temporal complexity of repolarization (RTmax-ApEn) independently predicts mortality in ICD patients. (PACE 2003; 26:1931–1936)
    Type of Medium: Electronic Resource
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