TY - JOUR
T1 - A reduction in the correlation dimension of heartbeat intervals precedes imminent ventricular fibrillation in human subjects
AU - Skinner, James E.
AU - Pratt, Craig
AU - Vybiral, Tomas
PY - 1993/3
Y1 - 1993/3
N2 - Reduced reflexive control of heartbeat intervals occurs with advanced heart disease and is an independent risk factor for mortality. Based on a previous study of experimental myocardial infarction in pigs, we hypothesized that a deterministic measure of heartbeat dynamics, the correlation dimension of R-R intervals (D2), may be a better predictor of risk than a stochastic measure, such as the standard deviation (SD). We determined the point estimates of the heartbeat D2 (i.e., PD2s) in Holter electrocardiographic recordings from 11 high-risk patients who manifested ventricular fibrillation (VF) during the recording and in high-risk controls having only nonsustained ventricular tachycardia (14 patients) or premature ventricular complexes (13 patients). We found that PD2 reduction (i.e., PD2s < 1.2) precedes lethal arrhythmias by hours, but is not reduced in high-risk controls (p < 0.001; sensitivity, 91%; specificity, 85%). Heartbeat SD did not discriminate among the patients. Thus PD2 of heartbeat intervals may provide an important diagnostic test and early warning sign of VF.
AB - Reduced reflexive control of heartbeat intervals occurs with advanced heart disease and is an independent risk factor for mortality. Based on a previous study of experimental myocardial infarction in pigs, we hypothesized that a deterministic measure of heartbeat dynamics, the correlation dimension of R-R intervals (D2), may be a better predictor of risk than a stochastic measure, such as the standard deviation (SD). We determined the point estimates of the heartbeat D2 (i.e., PD2s) in Holter electrocardiographic recordings from 11 high-risk patients who manifested ventricular fibrillation (VF) during the recording and in high-risk controls having only nonsustained ventricular tachycardia (14 patients) or premature ventricular complexes (13 patients). We found that PD2 reduction (i.e., PD2s < 1.2) precedes lethal arrhythmias by hours, but is not reduced in high-risk controls (p < 0.001; sensitivity, 91%; specificity, 85%). Heartbeat SD did not discriminate among the patients. Thus PD2 of heartbeat intervals may provide an important diagnostic test and early warning sign of VF.
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U2 - 10.1016/0002-8703(93)90165-6
DO - 10.1016/0002-8703(93)90165-6
M3 - Article
C2 - 7679868
AN - SCOPUS:0027408713
VL - 125
SP - 731
EP - 743
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 3
ER -