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Heart rate variability decreased by coronary artery surgery has no prognostic value

Goran Milicevic1, Ljubica Fort, Marcel Majsec

  • 1Division of Cardiology, General Hospital Sveti Duh, Sveti Duh 64, HR-10000 Zagreb, Croatia. goran.milicevic1@zg.hinet.hr

European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology
|June 5, 2004
PubMed

Insights

Decreased heart rate variability (HRV) predicts cardiac death in myocardial infarction (MI) patients. However, reduced HRV after coronary artery bypass grafting (CABG) surgery does not significantly impact survival outcomes.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • Decreased heart rate variability (HRV) is a known predictor of cardiac mortality following myocardial infarction (MI).
  • Coronary artery bypass grafting (CABG) surgery significantly reduces HRV but is associated with improved patient survival.
  • The prognostic value of HRV in patients undergoing CABG surgery requires further investigation.

Purpose of the Study:

  • To evaluate the prognostic significance of decreased heart rate variability (HRV) in patients after coronary artery bypass grafting (CABG).
  • To compare the prognostic value of HRV in patients who underwent CABG versus those who experienced myocardial infarction (MI).

Main Methods:

  • A 4-year follow-up study was conducted on 175 patients with reduced HRV post-CABG (n=51) or MI (n=124).
  • Heart rate variability was assessed using the standard deviation of mean RR interval (SDNN < 100 ms) via 24-h Holter ECG.
  • Mortality and secondary event rates were analyzed and compared between the two groups.

Main Results:

  • HRV was significantly lower in CABG patients (SDNN=66 ms) compared to MI patients (SDNN=77 ms).
  • Despite lower HRV, CABG patients exhibited significantly better survival (8% mortality) and event-free survival (10% events) compared to MI patients (33% mortality, 43% events) over 46 months.
  • In contrast to the MI group, HRV levels did not differ between survivors and non-survivors in the CABG group.

Conclusions:

  • Decreased heart rate variability (HRV) holds significant prognostic value for patients with myocardial infarction (MI).
  • In patients who have undergone coronary artery bypass grafting (CABG) surgery, decreased HRV does not appear to have prognostic significance for mortality or adverse events.
  • The prognostic implications of HRV differ substantially between patients with MI and those treated with CABG.
Abstract

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