Utility of heart rate turbulence and T-wave alternans to assess risk for readmission and cardiac death in hospitalized heart failure patients

Journal of Cardiovascular Electrophysiology
Shinya YamadaYasuchika Takeishi

Abstract

Heart failure (HF) patients have a higher risk of recurrent HF and cardiac death, and electrical remodeling is considered to be an important factor for HF progression. The present study aimed to validate the utility of electrocardiogram and Holter monitoring for the risk stratification of HF patients. Our study comprised 215 patients (144 males, mean age 62 years) who had been hospitalized due to acute decompensated HF. Electrocardiogram (QRS duration and QTc interval) and 24-hour Holter monitoring (heart rate variability, heart rate turbulence, and T-wave alternans [TWA]) were performed in stable condition before discharge. The clinical characteristics and outcomes were then investigated. During a median follow-up period of 2.7 years, there were 83 (38.6%) cardiac events (rehospitalization due to worsening HF [n = 51] or cardiac death [n = 32]). The patients with cardiac events had a lower turbulence slope (TS) and higher TWA compared to those without cardiac events (TS, 3.0 ± 5.5 ms/RR vs. 5.3 ± 5.6 ms/RR, P = 0.001; TWA, 66.1 ± 19.6 μV vs. 54.7 ± 15.1 μV, P < 0.001). Univariable analysis showed that TS, TWA, QRS duration, and QTc interval were associated with cardiac events (P = 0.004, P < 0.001, P = 0.037, and P = 0.024, re...Continue Reading

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Citations

Mar 1, 2019·Journal of Atherosclerosis and Thrombosis·Akiomi Yoshihisa, Yasuchika Takeishi
Feb 23, 2020·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Shinya YamadaYasuchika Takeishi
Jun 3, 2020·Physiological Measurement·Valeria BlesiusAndreas Dominik
Jan 8, 2020·European Heart Journal Supplements : Journal of the European Society of Cardiology·Piotr PonikowskiGiuseppe M C Rosano
Dec 2, 2020·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Shinya YamadaYasuchika Takeishi
Dec 19, 2020·Journal of Arrhythmia·Shinya YamadaYasuchika Takeishi

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