Cited by 289Heart Rate Variability and Autonomic ControlCardiac electrophysiology and arrhythmiasHeart Failure Treatment and Management

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Prognostic value of heart rate variability in chronic congestive heart failure (Veterans Affairs’ Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure)

Bilchick, Kenneth C, Fetics, Barry, Djoukeng, Ronnie, Gross Fisher, Susan, Fletcher, Ross D, Singh, Steven N, Nevo, Erez, Berger, Ronald D·2002·The American Journal of Cardiology

DOI 10.1016/s0002-9149(02)02380-9

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Abstract

Although the value of heart rate variability (HRV) for risk stratification after acute myocardial infarction has been demonstrated, the value of low HRV as a predictor of sudden cardiac death in patients with ischemic cardiomyopathy has not been shown convincingly to date. We retrospectively analyzed electrocardiographic data from 179 patients in the Veterans Affairs' Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure to determine if HRV (expressed as the SD of the normal-to-normal RR intervals [SDNN]) would be useful as a predictor of overall mortality and sudden death. Because our goal was to identify high-risk patients, we compared patients in the lowest quartile of HRV with the remaining patients. Among the 127 patients meeting inclusion criteria, SDNN <65.3 ms (the lowest quartile) was the sole independent factor predictive of survival in a multivariate model (p = 0.0001). A Cox proportional-hazards model revealed that each increase of 10 ms in SDNN conferred a 20% decrease in risk of mortality (p = 0.0001). Furthermore, patients with SDNN <65.3 ms had a significantly increased risk of sudden death (p = 0.016). Thus, HRV was the sole independent predictor of overall mortality and was significantly associated with sudden death in this population.

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Authors: Bilchick, K. C., Fetics, B., Djoukeng, R., Gross Fisher, S., Fletcher, R. D., Singh, S. N., Nevo, E., & Berger, R. D.
Affiliations: Johns Hopkins University (US)
United States Department of Veterans Affairs (US)
ORCID: Bilchick, Kenneth C
Singh, Steven N
Berger, Ronald D
Venue: The American Journal of Cardiology
Publisher: Elsevier BV
Published: 2002-07
Volume: 90
Issue: 1
Pages: 24-28
ISSN: 0002-9149 (ISSN-L)
DOI: 10.1016/s0002-9149(02)02380-9
OpenAlex: W2122859962
Cited by: 288
References: 20
Citations by year: 2026: 3 · 2025: 3 · 2024: 8 · 2023: 6 · 2022: 3 · 2021: 17 · 2020: 13 · 2019: 12 · 2018: 12 · 2017: 14 · 2016: 10 · 2015: 9 · 2014: 16 · 2013: 15 · 2012: 10
FWCI: 10.92
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The American Journal of Cardiology (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r44hl061903-03)
National Heart, Lung, and Blood Institute (P50-HL52307, P50HL052307, R44 HL61903)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Keywords: heart rate variability, chronic congestive heart failure, SDNN, all-cause mortality, sudden cardiac death, risk stratification, antiarrhythmic therapy, veterans
MeSH terms: Aged, Amiodarone, Anti-Arrhythmia Agents, Arrhythmias, Cardiac, Chronic Disease, Female, Heart Failure, Heart Rate, Humans, Male, Predictive Value of Tests, Prognosis, Retrospective Studies, Risk Factors, Stroke Volume, United States, United States Department of Veterans Affairs, Electrocardiography, Ambulatory, Comorbidity, Multivariate Analysis, Proportional Hazards Models, Survival Analysis, Death, Sudden, Cardiac, Myocardial Ischemia

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Prognostic value of heart rate variability in chronic congestive heart failure (Veterans Affairs’ Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure)

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