Heart rate (HR) variability has been extensively studied in patients surviving an acute myocardial infarction (AMI). The majority of studies have shown that patients with reduced or abnormal HR variability/turbulence have an increased risk of mortality within few years after an AMI. Various measures of HR dynamics, such as time-domain, spectral, and non-linear measures of HR variability, as well as HR turbulence, have been used in risk stratification of post-AMI patients. The prognostic power of various measures, except of those reflecting rapid R–R interval oscillations, has been almost identical, albeit some non-linear HR variability measures, such as short-term fractal scaling exponent, and HR turbulence, have provided somewhat better prognostic information than the others. Abnormal HR variability predicts both sudden and non-sudden cardiac death after AMI. Because of remodeling of the arrhythmia substrate after AMI, early measurement of HR variability to identify those at high risk should likely be repeated later in order to assess the risk of fatal arrhythmia events. Future randomized trials using HR variability/turbulence as one of the pre-defined inclusion criteria will show whether routine measurement of HR variability/turbulence will become a routine clinical tool for risk stratification of post-AMI patients.
Keywords: mortality, coronary artery disease, sudden cardiac death
Citation: Huikuri HV and Stein PK (2012) Clinical application of heart rate variability after acute myocardial infarction. Front. Physio. 3:41. doi: 10.3389/fphys.2012.00041
Received: 21 December 2011; Paper pending published: 09 January 2012;
Accepted: 13 February 2012; Published online: 27 February 2012.
Edited by:Federico Lombardi, University of Milan, Italy
Reviewed by:Marko S. Laaksonen, Mid Sweden University, Sweden
Copyright: © 2012 Huikuri and Stein. This is an open-access article distributed under the terms of the Creative Commons Attribution Non Commercial License, which permits non-commercial use, distribution, and reproduction in other forums, provided the original authors and source are credited.
*Correspondence: Heikki V. Huikuri, Department of Internal Medicine, Institute of Clinical Medicine, University of Oulu, P.O. Box 5000 (Kajaanintie 50), FIN-90014 Oulu, Finland. e-mail: firstname.lastname@example.org