A reduction in the correlation dimension of heartbeat intervals precedes imminent ventricular fibrillation in human subjects

James E. Skinner, Craig Pratt, Tomas Vybiral

Research output: Contribution to journalArticle

198 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)731-743
Number of pages13
JournalAmerican Heart Journal
Volume125
Issue number3
DOIs
StatePublished - Mar 1993

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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