[R-R variability in acute anterior infarct after thrombolytic therapy]

To analyse the effects of thrombolysis on the integrity of the autonomic nervous system, in patient with acute myocardial infarction (AMI) of the anterior wall, using the determination of the heart rate variability.

We prospectively evaluated the R-R variability of the 31 consecutive patients with anterior AMI submitted to coronary thrombolysis (25 males; mean age 59 +/- 14 years) from Holter tapes. An algorithm in a 286 computer program was used for heart rate variability (HRV). With this system, R-R variations during sinus rhythm and for a five consecutive minutes periods was determined. The results were expressed as the mean of the total determined periods; the standard deviation of the mean of all determined periods and the mean of the standard deviation. The reperfusion criteria was the early enzymatic rise of the CKMB activity levels (< or = 12 h) combined with a 50% or more reduction in the ST segment elevation within the first hour after thrombolytic therapy and the presence of an accelerated idioventricular rhythm at the same time. The reperfused group (group 1 = 16 patients) and non-reperfused group (group 2 = 15 patients) were compared in terms of R-R variability.

Mean R-R: group 1 = 716 +/- 84 ms (540-820 ms); group 2 = 595 +/- 115 ms (390-870 ms)-p < 0.02. ms (34-92 ms); group 2 = 50 +/- 14 ms (23-77 ms)-p < 0.01. HRV 50 ms: group 1 = 2 patients; group 2 = 5 patients. Means SD of the R-R: group 1 = 44 +/- 14 ms (26-65 ms); group 2 = 39 +/- 17 ms (19-69 ms)-p: ns.

Patients with anterior AMI and thrombolytic therapy demonstrate greater HRV; this finding suggested better integrity of the autonomic nervous system, with possible effects on prognosis.