V-shaped trough in autonomic activity is a possible precursor of life-threatening cardiac events

Motohisa Osaka, Eiichi Watanabe, Hiroshige Murata, Yoshitaka Fuwamoto, Shinji Nanba, Kazuhiro Sakai, Takao Katoh

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Abstract

Background: No reliable precursor of sudden cardiac death is known. Methods and Results: Holter electrocardiograms of 34 patients experiencing a cardiac event (event group, 20 deaths) were compared with 191 controls (no event group). The event group included 25 patients with ventricular fibrillation or acute myocardial infarction (AMI), and 9 with cardiac arrest due to complete atrioventricular block. The logarithms were calculated of the moving average of 5 successive values for the low-frequency component (LF), the high-frequency component (HF), and the ratio LF/HF of heart rate variability: ln(LF), ln(HF) and ln(LF/HF). A V-shaped trough appeared in the curve of ln(LF/HF) [sV-trough] or ln(HF) [pV-trough] before such an event in 31 patients in the event group. The V-trough was marked by a small variation lasting 2 h, an abrupt descent lasting 30 min, and a sharp ascent for 40 min. An sV-trough was observed in 22 patients before the onset of ventricular fibrillation or AMI. A pV-trough was observed in all 9 patients before the onset of complete atrioventricular block. In the no event group, an sV-trough and a pV-trough were observed in 10 subjects (5%) and 20 subjects (10%), respectively. The positive predictive accuracy of an sV-trough for ventricular fibrillation or AMI and that of a pV-trough for complete atrioventricular block was 88% and 100%, respectively. Conclusions: A previously unidentified V-trough of autonomic activity is a potential precursor of lethal events.

Original languageEnglish
Pages (from-to)1906-1915
Number of pages10
JournalCirculation Journal
Volume74
Issue number9
DOIs
Publication statusPublished - 03-09-2010

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Atrioventricular Block
Ventricular Fibrillation
Myocardial Infarction
Sudden Cardiac Death
Heart Arrest
Electrocardiography
Heart Rate

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Osaka, Motohisa ; Watanabe, Eiichi ; Murata, Hiroshige ; Fuwamoto, Yoshitaka ; Nanba, Shinji ; Sakai, Kazuhiro ; Katoh, Takao. / V-shaped trough in autonomic activity is a possible precursor of life-threatening cardiac events. In: Circulation Journal. 2010 ; Vol. 74, No. 9. pp. 1906-1915.
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abstract = "Background: No reliable precursor of sudden cardiac death is known. Methods and Results: Holter electrocardiograms of 34 patients experiencing a cardiac event (event group, 20 deaths) were compared with 191 controls (no event group). The event group included 25 patients with ventricular fibrillation or acute myocardial infarction (AMI), and 9 with cardiac arrest due to complete atrioventricular block. The logarithms were calculated of the moving average of 5 successive values for the low-frequency component (LF), the high-frequency component (HF), and the ratio LF/HF of heart rate variability: ln(LF), ln(HF) and ln(LF/HF). A V-shaped trough appeared in the curve of ln(LF/HF) [sV-trough] or ln(HF) [pV-trough] before such an event in 31 patients in the event group. The V-trough was marked by a small variation lasting 2 h, an abrupt descent lasting 30 min, and a sharp ascent for 40 min. An sV-trough was observed in 22 patients before the onset of ventricular fibrillation or AMI. A pV-trough was observed in all 9 patients before the onset of complete atrioventricular block. In the no event group, an sV-trough and a pV-trough were observed in 10 subjects (5{\%}) and 20 subjects (10{\%}), respectively. The positive predictive accuracy of an sV-trough for ventricular fibrillation or AMI and that of a pV-trough for complete atrioventricular block was 88{\%} and 100{\%}, respectively. Conclusions: A previously unidentified V-trough of autonomic activity is a potential precursor of lethal events.",
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V-shaped trough in autonomic activity is a possible precursor of life-threatening cardiac events. / Osaka, Motohisa; Watanabe, Eiichi; Murata, Hiroshige; Fuwamoto, Yoshitaka; Nanba, Shinji; Sakai, Kazuhiro; Katoh, Takao.

In: Circulation Journal, Vol. 74, No. 9, 03.09.2010, p. 1906-1915.

Research output: Contribution to journalArticle

TY - JOUR

T1 - V-shaped trough in autonomic activity is a possible precursor of life-threatening cardiac events

AU - Osaka, Motohisa

AU - Watanabe, Eiichi

AU - Murata, Hiroshige

AU - Fuwamoto, Yoshitaka

AU - Nanba, Shinji

AU - Sakai, Kazuhiro

AU - Katoh, Takao

PY - 2010/9/3

Y1 - 2010/9/3

N2 - Background: No reliable precursor of sudden cardiac death is known. Methods and Results: Holter electrocardiograms of 34 patients experiencing a cardiac event (event group, 20 deaths) were compared with 191 controls (no event group). The event group included 25 patients with ventricular fibrillation or acute myocardial infarction (AMI), and 9 with cardiac arrest due to complete atrioventricular block. The logarithms were calculated of the moving average of 5 successive values for the low-frequency component (LF), the high-frequency component (HF), and the ratio LF/HF of heart rate variability: ln(LF), ln(HF) and ln(LF/HF). A V-shaped trough appeared in the curve of ln(LF/HF) [sV-trough] or ln(HF) [pV-trough] before such an event in 31 patients in the event group. The V-trough was marked by a small variation lasting 2 h, an abrupt descent lasting 30 min, and a sharp ascent for 40 min. An sV-trough was observed in 22 patients before the onset of ventricular fibrillation or AMI. A pV-trough was observed in all 9 patients before the onset of complete atrioventricular block. In the no event group, an sV-trough and a pV-trough were observed in 10 subjects (5%) and 20 subjects (10%), respectively. The positive predictive accuracy of an sV-trough for ventricular fibrillation or AMI and that of a pV-trough for complete atrioventricular block was 88% and 100%, respectively. Conclusions: A previously unidentified V-trough of autonomic activity is a potential precursor of lethal events.

AB - Background: No reliable precursor of sudden cardiac death is known. Methods and Results: Holter electrocardiograms of 34 patients experiencing a cardiac event (event group, 20 deaths) were compared with 191 controls (no event group). The event group included 25 patients with ventricular fibrillation or acute myocardial infarction (AMI), and 9 with cardiac arrest due to complete atrioventricular block. The logarithms were calculated of the moving average of 5 successive values for the low-frequency component (LF), the high-frequency component (HF), and the ratio LF/HF of heart rate variability: ln(LF), ln(HF) and ln(LF/HF). A V-shaped trough appeared in the curve of ln(LF/HF) [sV-trough] or ln(HF) [pV-trough] before such an event in 31 patients in the event group. The V-trough was marked by a small variation lasting 2 h, an abrupt descent lasting 30 min, and a sharp ascent for 40 min. An sV-trough was observed in 22 patients before the onset of ventricular fibrillation or AMI. A pV-trough was observed in all 9 patients before the onset of complete atrioventricular block. In the no event group, an sV-trough and a pV-trough were observed in 10 subjects (5%) and 20 subjects (10%), respectively. The positive predictive accuracy of an sV-trough for ventricular fibrillation or AMI and that of a pV-trough for complete atrioventricular block was 88% and 100%, respectively. Conclusions: A previously unidentified V-trough of autonomic activity is a potential precursor of lethal events.

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U2 - 10.1253/circj.CJ-09-0935

DO - 10.1253/circj.CJ-09-0935

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VL - 74

SP - 1906

EP - 1915

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 9

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