Insights from the study of heart rate variability

Research output: Contribution to journalReview article

368 Scopus citations

Abstract

Indices of heart rate variability (HRV) provide a window onto autonomic modulation of the heart. HRV indices, determined in either the time or frequency domain, are closely related and reflect parasympathetic, mixed sympathetic, and parasympathetic and circadian rhythms. In population studies, decreased HRV has had predictive value for mortality among healthy adults. It is a well-established risk factor for arrhythmic events and mortality among post-myocardial-infarction patients but has only moderate sensitivity and specificity. Decreased HRV has had mixed predictive success in congestive heart failure. Reduced HRV identifies diabetic patients with autonomic neuropathy. HRV in combination with other risk stratifiers, e.g. ejection fraction, can identify cardiac patients at especially high risk of mortality. Many but not all interventions associated with increased HRV are also associated with better survival rates.

Original languageEnglish
Pages (from-to)249-261
Number of pages13
JournalAnnual review of medicine
Volume50
DOIs
StatePublished - Mar 17 1999

Keywords

  • Cardiac autonomic modulation
  • Heart rate variability
  • Risk stratification

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