Supplementary Files
Keywords
How to Cite
Abstract
Objective: To compare effect of reperfusion by measuring time domain parameters of heart rate variability before and after percutaneous transluminal coronary angioplasty. Study design: Quasi experimental study design Place and Duration: Department of Clinical Cardiac Electrophysiology, Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi from January 2014 till January 2015. Patients and Methods: 40 patients with coronary artery disease having mean age of 55.20 ± 8.03 years were recruited by non-probability convenience sampling. DMS 300-4A Holter monitors were used to obtain 24 hours ambulatory ECG recording before and within 24 hours after percutaneous transluminal coronary angioplasty. Digital ECG data were transferred to the computer and edited with the help of DMS Cardioscan software. Heart rate variability was analysed in time domains measures. For time domain analysis normal heart rate, SDNN, SDNNi, SDANN, RMSSD and pNN50 were recorded from 12 lead digital ECG data.
Results: The results of our study demonstrated significantly decreased heart rate variability in coronary artery disease patients on comparison of pre and post-angioplasty values only SDNNi was significantly reduced (p-value = 0.035) whereas the reduction in SDNN and pNN50 was statistically insignificant (p-value > 0.05). On the contrary, SDANN and RMSSD displayed slight rise after angioplasty but it was not significant (p-value > 0.05).
Conclusion: Reperfusion after percutaneous transluminal coronary angioplasty decreases heart rate variability within 24 hours after the procedure. Whereas, heart rate during the same period after angioplasty increases. This reflects autonomic balance shifts towards sympathetic predominance as indicated by reduced heart rate variability and rise in heart rate. This makes the susceptible patients vulnerable for development of ventricular arrhythmias especially during 24 hours after angioplasty. Therefore, patients with decreased heart rate variability are at risk of ventricular arrhythmogenesis so they may be kept under medical surveillance for at least 24 hours after percutaneous transluminal coronary angioplasty.
References
Nowbar AN, Gitto M, Howard JP, Francis DP, Al-Lamee R. Mortality from ischemic heart disease: Analysis of data from the World Health Organization and coronary artery disease risk factors From NCD Risk Factor Collaboration. Circulation: cardiovascular quality and outcomes. 2019;12(6):e005375.
Lee S, Li G, Liu T, Tse G. COVID-19: Electrophysiological mechanisms underlying sudden cardiac death during exercise with facemasks. Medical Hypotheses. 2020;144:110177.
Olshansky B, Ricci F, Fedorowski A. Importance of Resting Heart Rate: Heart rate and Outcomes. Trends in Cardiovascular Medicine. 2022.
Ebrahimzadeh E, Pooyan M, Bijar A. A novel approach to predict sudden cardiac death (SCD) using nonlinear and time-frequency analyses from HRV signals. PLoS One. 2014;9(2):e81896.
Vorobiev A, Vaykhanskaya T, Melnikova O, Krupenin V, Polyakov V, Frolov A. A Digital Electrocardiographic System for Assessing Myocardial Electrical Instability: Principles and Applications. Современные технологии в медицине. 2020;12(6 (eng)):15-9.
Schafer A, Vagedes J. How accurate is pulse rate variability as an estimate of heart rate variability? A review on studies comparing photoplethysmographic technology with an electrocardiogram. Int J Cardiol. 2013;166(1):15-29.
Quiroz-Juarez MA, Jimenez-Ramirez O, Vazquez-Medina R, Ryzhii E, Ryzhii M, Aragon JL. Cardiac conduction model for generating 12 lead ECG signals with realistic heart rate dynamics. IEEE transactions on nanobioscience. 2018;17(4):525-32.
Li C, Chang Q, Zhang J, Chai W. Effects of slow breathing rate on heart rate variability and arterial baroreflex sensitivity in essential hypertension. Medicine. 2018;97(18).
Schuurmans AA, de Looff P, Nijhof KS, Rosada C, Scholte RH, Popma A, et al. Validity of the Empatica E4 wristband to measure heart rate variability (HRV) parameters: A comparison to electrocardiography (ECG). Journal of medical systems. 2020;44(11):1-11.
Mubarak S, Majeed MI, Khan MA. Time domain analysis of heart rate variability in patients with coronary artery disease. Pakistan Journal of Physiology. 2014;10(1-2):21–4-–4.
Pathak K. Comparative Analysis of Heart Rate Variability Signals 2018.
Fujita H, Acharya UR, Sudarshan VK, Ghista DN, Sree SV, Eugene LWJ, et al. Sudden cardiac death (SCD) prediction based on nonlinear heart rate variability features and SCD index. Applied Soft Computing. 2016;43:510-9.
Pourhanifeh MH, Dehdashtian E, Hosseinzadeh A, Sezavar SH, Mehrzadi S. Clinical application of melatonin in the treatment of cardiovascular diseases: current evidence and new insights into the cardioprotective and cardiotherapeutic properties. Cardiovascular Drugs and Therapy. 2020:1-25.
Colli-Franzone P, Gionti V, Pavarino L, Scacchi S, Storti C. Role of infarct scar dimensions, border zone repolarization properties and anisotropy in the origin and maintenance of cardiac reentry. Mathematical biosciences. 2019;315:108228.
Figueiredo TdG, de Souza HCM, Neves VR, do Rêgo Barros AEV, Dornelas de Andrade AdF, Brandão DC. Effects of physical exercise on the autonomic nervous system in patients with coronary artery disease: A systematic review. Expert Review of Cardiovascular Therapy. 2020;18(11):749-59.
Vaseghi M, Shivkumar K. The role of the autonomic nervous system in sudden cardiac death. Prog Cardiovasc Dis. 2008;50(6):404-19.
Cascio WE. Myocardial ischemia: what factors determine arrhythmogenesis? J Cardiovasc Electrophysiol. 2001;12(6):726-9.
Gourley B. Exploring the relationship between anxiety sensitivity and heart rate variability: Eastern Michigan University; 2019.
Myerburg RJ, Junttila MJ. Sudden cardiac death caused by coronary heart disease. Circulation. 2012;125(8):1043-52.
Szwoch M, Ambroch-Dorniak K, Sominka D, Dorniak W, Daniłowicz-Szymanowicz L, Krassowski W, et al. Comparison the effects of recanalisation of chronic total occlusion of the right and left coronary arteries on the autonomic nervous system function. Kardiologia polska. 2009;67(5):467-74.
Verkuil B, Brosschot JF, Meerman EE, Thayer JF. Effects of momentary assessed stressful events and worry episodes on somatic health complaints. Psychology & health. 2012;27(2):141-58.
Pieper S, Brosschot JF, van der Leeden R, Thayer JF. Prolonged cardiac effects of momentary assessed stressful events and worry episodes. Psychosomatic Medicine. 2010;72(6):570-7.
Pilz PM, Lang M, Hamza O, Szabo PL, Inci M, Kramer AM, et al. Semi-Minimal Invasive Method to Induce Myocardial Infarction in Rats and the Assessment of Cardiac Function by an Isolated Working Heart System. JoVE (Journal of Visualized Experiments). 2020(160):e61033.
Jennings RB. Historical perspective on the pathology of myocardial ischemia/reperfusion injury. Circulation research. 2013;113(4):428-38.
Sarja H, Anttila T, Mustonen C, Honkanen H-P, Herajarvi J, Haapanen H, et al., editors. Diazoxide attenuates ischemic myocardial injury in a porcine model. Heart Surgery Forum; 2017.
Erdoğan E, Akkaya M, Bacaksız A, Tasal A, Kul S, Turfan M, et al. Short Term Effect of Percutaneous Recanalization of Chronic Total Occlusions on QT Dispersion and Heart Rate Variability Parameters. Journal of the American College of Cardiology. 2013;62(18_S2):C200-C.
Sedziwy E, Olszowska M, Tracz W, Pieniazek P. [Heart rate variability in patients treated with percutaneous transluminal coronary angioplasty]. Przegl Lek. 2002;59(9):695-8.
Lin I-M, Fan S-Y, Lu H-C, Lin T-H, Chu C-S, Kuo H-F, et al. Randomized controlled trial of heart rate variability biofeedback in cardiac autonomic and hostility among patients with coronary artery disease. Behaviour research and therapy. 2015;70:38-46.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Copyright (c) 2023 SIDRA HAMID SIDRA HAMID