The predictive value of deceleration capacity of heart rate for sudden cardiac death after acute myocardial infarction / 天津医药

ABSTRACT

Objective To investigate the predictive value of the non-invasive indicator deceleration capacity of heart rate (DC) in the sudden cardiac death (SCD) after acute myocardial infarction. Methods A total of 417 myocardial infarc?tion patients with ST-segment elevation in sinus rhythm were enrolled in this study. DC was assessed from data of 24-hour ECG Holter. Regular follow-ups were carried out within 12 months. The SCD events were recorded and compared with pa?tients without SCD. Results During 12 months of follow-up, 20 patients were died due to SCD (4.8%). Compared with sur?vival group, patients showed significantly lower left ventricular ejection fraction (LVEF, 0.393 ± 0.065 vs 0.528 ± 0.042, P<0.05) and DC [(2.85±1.66) ms vs (5.49±1.71) ms,P<0.05]in SCD group. Multivariate Cox proportional hazard regression analysis showed that lower LVEF(<0.35)[RR 2.167(1.384-4.661), P=0.013]and DC (DC<4.5 ms)[RR 3.706(2.709-5.374),P=0.020]were risk factors for the occurrence of SCD. The prediction sensitivity by the decreased LVEF and DC was 52.1%and 76.4%respectively, and the specificity was 84.5%and 86.1%respectively. Conclusion The decreased value of DC after acute myocardial infarction can predict the SCD events.