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Late potentials and heart rate variability in heart muscle disease

E G Vester1, C Emschermann, U Stobbe

  • 1Medical Clinic, Heinrich-Heine-University Düsseldorf, Germany.

European Heart Journal
|August 1, 1994
PubMed

Insights

Ventricular late potentials (LP) and reduced heart rate variability (HRV) are significant indicators in heart muscle diseases. The signal-averaged QRS complex duration independently predicts severe arrhythmias and sudden cardiac death.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Internal Medicine

Background:

  • Ventricular late potentials (LP) and reduced heart rate variability (HRV) are markers of cardiac electrical instability.
  • Their incidence and clinical significance in various heart muscle diseases require elucidation.

Purpose of the Study:

  • To determine the prevalence and clinical importance of LP and reduced HRV.
  • To investigate these markers in dilated cardiomyopathy (DCM), chronic myocarditis (MC), hypertrophic cardiomyopathy (HCM), and systemic hypertension (HT).

Main Methods:

  • Studied 157 patients with DCM, MC, HCM, and HT.
  • Utilized signal averaging for LP detection and Holter monitoring for arrhythmias.
  • Performed electrophysiological studies (EPS) for inducibility of ventricular tachycardia (VT) or fibrillation (VF).
  • Measured HRV using RR interval standard deviation (HRV-SD).

Main Results:

  • LP found in 24% of patients; highest in DCM (47%).
  • Complex ventricular arrhythmias detected in 56% of DCM patients.
  • VT/VF inducible in 32% of MC patients during EPS.
  • Signal-averaged QRS duration was the sole independent predictor of severe arrhythmic events and sudden cardiac death.
  • HRV was most reduced in DCM patients (HRV-SD 39 ± 23 ms).

Conclusions:

  • LP and reduced HRV are prevalent in heart muscle diseases, particularly DCM.
  • Signal-averaged QRS complex duration is a critical prognostic factor for adverse cardiac events.
  • Further research into these markers can improve risk stratification for sudden cardiac death.

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