Early Time Course of Heart Rate Variability after Thrombolytic and Delayed Interventional Therapy for Acute Myocardial Infarction

Abstract

In 89 of 97 consecutive patients with myocardial infarction (MI) undergoing thrombolysis and delayed early coronary angiography with PTCA, if indicated, heart rate variability (HRV) in time domain was evaluable 40 ± 11 h after the onset of chest pain using 24-hour ECG recordings. Patients with anterior MI (n = 40) had lower values for HRV and left ventricular ejection fraction (p < 0.05). The mean of all 5-min standard deviations of RR intervals (SDNNi) and the root-mean-square difference of successive RR intervals (rMSSD) decreased significantly (p < 0.001 each), whereas the standard deviation of all normal RR intervals and the percentage of absolute differences between successive RR intervals only showed a tendency to lower values 4 weeks after MI (p = 0.20 and 0.08, respectively). The decreases in SDNNi and rMSSD were more evident in inferior than in anterior MI. The time course of HRV following MI was similar in patients with and without PTCA. These results indicate an initial vagal hyperactivity in inferior MI, which is quickly predominated by sympathetic activation and a prolonged recovery of the cardiac autonomic imbalance after MI despite a successful combined reperfusion therapy.

Journal

Journal ID (publisher-id): CRD

Journal ID (nlm-ta): Cardiology

Journal ID (doi): 10.1159/issn.0008-6312

Title: Cardiology

Publisher: S. Karger AG

ISSN (Print): 0008-6312

ISSN (Electronic): 1421-9751

Publication date Subscription-year: 1999

Publication date (Print): April 2000

Publication date (Electronic): 19 April 2000

Volume: 92

Issue: 4

Pages: 256-263

Affiliations

Departments of Internal Medicine III, ^aFriedrich Schiller University, Jena and ^bUniversity Hospital of the Saarland, Homburg, and ^cDepartment of Cardiology, District Hospital, Völklingen, Germany

Article

Publisher ID: 6983 Other ID: Cardiology 1999;92:256–263

DOI: 10.1159/000006983

PubMed ID: 10844386

Copyright statement: © 2000 S. Karger AG, Basel

License:

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Page count

Tables: 6, References: 33, Pages: 8

Product

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Categories

Subject: Coronary Care