Association of Heart Rate Variability With Arrhythmic Events in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia

Irma Battipaglia; Giancarla Scalone; Andrea Macchione; Gaetano Pinnacchio; Marianna Laurito; Maria Milo; Gemma Pelargonio; Gianluigi Bencardino; Fulvio Bellocci; Maurizio Pieroni; Gaetano A. Lanza; Filippo Crea

doi:10.1253/circj.CJ-11-1052

Arrhythmia/Electrophysiology

Association of Heart Rate Variability With Arrhythmic Events in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia

Irma Battipaglia, Giancarla Scalone, Andrea Macchione, Gaetano Pinnacchio, Marianna Laurito, Maria Milo, Gemma Pelargonio, Gianluigi Bencardino, Fulvio Bellocci, Maurizio Pieroni, Gaetano A. Lanza, Filippo Crea

Author information

Irma Battipaglia
Department of Cardiovascular Medicine, Cardiology Center, Catholic University of the Sacred Heart
Giancarla Scalone
Department of Cardiovascular Medicine, Cardiology Center, Catholic University of the Sacred Heart
Andrea Macchione
Department of Cardiovascular Medicine, Cardiology Center, Catholic University of the Sacred Heart
Gaetano Pinnacchio
Department of Cardiovascular Medicine, Cardiology Center, Catholic University of the Sacred Heart
Marianna Laurito
Department of Cardiovascular Medicine, Cardiology Center, Catholic University of the Sacred Heart
Maria Milo
Department of Cardiovascular Medicine, Cardiology Center, Catholic University of the Sacred Heart
Gemma Pelargonio
Department of Cardiovascular Medicine, Cardiology Center, Catholic University of the Sacred Heart
Gianluigi Bencardino
Department of Cardiovascular Medicine, Cardiology Center, Catholic University of the Sacred Heart
Fulvio Bellocci
Department of Cardiovascular Medicine, Cardiology Center, Catholic University of the Sacred Heart
Maurizio Pieroni
Department of Cardiovascular Medicine, Cardiology Center, Catholic University of the Sacred Heart
Gaetano A. Lanza
Department of Cardiovascular Medicine, Cardiology Center, Catholic University of the Sacred Heart
Filippo Crea
Department of Cardiovascular Medicine, Cardiology Center, Catholic University of the Sacred Heart

Keywords: Arrhythmogenic right ventricular cardiomyopathy/dysplasia, Heart rate variability, Sudden cardiac death, Sustained ventricular tachycardia

JOURNAL FREE ACCESS

2012 Volume 76 Issue 3 Pages 618-623

DOI https://doi.org/10.1253/circj.CJ-11-1052

View "Advance Publication" version (January 20, 2012).

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Abstract

Background: Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is associated with an increased risk of sudden cardiac death (SCD). Risk stratification of ARVC/D patients, however, remains an unresolved issue. In this study we investigated whether heart rate variability (HRV) can be helpful in identifying ARVC/D patients with increased risk of arrhythmic events. Methods and Results: We studied 30 consecutive patients (17 males; 45.4±18 years) with ARVC/D, diagnosed according to guideline criteria; 15 patients (50%) had received an implantable cardioverter defibrillator (ICD) for primary SCD prevention. HRV was assessed on 24-h ECG Holter monitoring. The primary endpoint was the occurrence of major arrhythmic events (SCD, sustained ventricular tachycardia (VT), ICD therapy for sustained VT or ventricular fibrillation (VF)). During the follow-up period (19±7 months), no deaths occurred, but 5 patients (17%) experienced arrhythmic events (4 VTs and 1 VF, all in the ICD group). All HRV parameters were significantly lower in patients with, compared with those without, arrhythmic events. Low-frequency amplitude was the most significant HRV variable associated with arrhythmic events in univariate Cox regression analysis (P=0.017), and was the only significant predictor of arrhythmic events in multivariable regression analysis (hazard ratio 0.88, P=0.047), together with unexplained syncope (hazard ratio 16.1, P=0.039). Conclusions: Our data show that among ARVC/D patients HRV analysis might be helpful in identifying those with increased risk of major arrhythmic events. (Circ J 2012; 76: 618-623)

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