Estudo do comportamento autonômico dos ritmos de escape no bloqueio atrioventricular congênito / Study of the Autonomic Behavior of the Escape Rhythms in Complete Congenital Heart Block

ABSTRACT

PURPOSE--To study the autonomic behavior of the escape rhythm in congenital complete heart block (CCHB), using heart rate variability (HRV). METHODS--A group of 10 asymptomatic patients with CCHB and narrow QRS was studied, 7 females; mean age = 14 +/- 9 years. The following time domain indexes were analyzed from a 24 hour Holter monitoring. The mean of all RR intervals (NN); the standard deviation of the mean (CLV5); the mean of all standard deviations (SDNN); the percent of successive differences longer than 50 ms (pNN50); the shortest cycle (CC) and the longest cycle (CL). The results were compared with a control group, using the Wilcox test for statistical analysis. RESULTS--The results were NN = 1016 +/- 276 ms in CHB and 725 +/- 121 ms in control (p < 0.01); CLV5 = 184 +/- 97 ms in CHB and 125 +/- 38 ms in control (p = NS); SDNN = 102 +/- 32 ms in CHB and 88 +/- 29 ms in control (p = NS); rMSSD = 113 +/- 69 ms in CHB and 78 +/- 28 ms in control (p = NS); pNN50 = 43 +/- 26 per cent in CHB and 33 +/- 12 per cent in control (p = NS); CC = 582 +/- 129 ms in CHB and 333 +/- 49 ms in control (p = 0.05). CONCLUSION--No statistical difference was noted by comparing HRV indexes in CHB with control subjects, showing that the autonomic behavior of the escape rhythm in CCHB is similar to the sinus node in asymptomatic patients. The differences in NN, CC and CL are probably related to intrinsic properties of each command