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
N1 - Funding Information:
From the Neurophysiology Section, Department of Neurology, and Cardiology Section, Department of Medicine, Baylor College of Medicine. Supported by National Institutes of Health grants HL31164 and NS27745 (Dr. Skinner). Received for publication June 1, 1992; accepted Sept. 25, 1992. Reprint requests: Tomas Vybiral, MD, Cardiology Section, Methodist Hospital-MSF 905, 6535 Fannin, Houston, TX 77030. Copyright ‘( 1993 by Mosby-Year Book, Inc. 0002.8703/93/$1.00 + .lO 4/l/43355
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
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 -