Heart rate variability in neurosurgical patients

Neurosurgery
T J Leipzig, R I Lowensohn

Abstract

Cardiac monitors determine heart rate by counting the number of beats in a given time interval. The normal heart, however, does not beat at a constant rate. Instead, there is a continuous change in heart rate on a beat-by-beat basis. This is termed the instantaneous heart rate and it represents the projected rate per minute that the heart would beat if only one R-R interval (the time between sequential R waves) was repeated throughout a 60-second period. Calculation of the instantaneous heart rate for each heart beat (R-R interval) produces a pattern that demonstrates the variability in heart rate. This instantaneous heart rate pattern was prospectively studied in 102 patients admitted to a neurosurgical intensive care unit. Short-term (STV) and long-term (LTV) heart rate variability were compared to the Glasgow coma scale as a method for patient assessment. LTV seems to be the most useful heart rate parameter in the clinical setting, and both STV and LTV performed better in the serial evaluation of patients. Two postulations found in the heart rate literature were not borne out in this study. First, we did not find a strong correlation between elevated intracranial pressure and decreases in heart rate or variability, as previo...Continue Reading

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