دورية أكاديمية
Diurnal Variation in and Optimal Time to Measure Holter-Based Late Potentials to Predict Lethal Arrhythmia after Myocardial Infarction
| العنوان: | Diurnal Variation in and Optimal Time to Measure Holter-Based Late Potentials to Predict Lethal Arrhythmia after Myocardial Infarction |
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| المؤلفون: | Kenichi Hashimoto, Naomi Harada, Motohiro Kimata, Yusuke Kawamura, Naoya Fujita, Akinori Sekizawa, Yosuke Ono, Yasuhiro Obuchi, Tadateru Takayama, Yuji Kasamaki, Yuji Tanaka |
| المصدر: | Medicina, Vol 59, Iss 8, p 1460 (2023) |
| بيانات النشر: | MDPI AG, 2023. |
| سنة النشر: | 2023 |
| المجموعة: | LCC:Medicine (General) |
| مصطلحات موضوعية: | late potentials, signal-averaged electrocardiography, heart rate variability, fatal arrhythmia, sudden cardiac death, Medicine (General), R5-920 |
| الوصف: | Background and Objectives: Holter-based late potentials (LPs) are useful for predicting lethal arrhythmias in organic cardiac diseases. Although Holter-based LPs exhibit diurnal variation, no studies have evaluated the optimal timing of LP measurement over 24 h for predicting lethal arrhythmia that leads to sudden cardiac death. Thus, this study aimed to validate the most effective timing for Holter-based LP testing and to explore factors influencing the diurnal variability in LP parameters. Materials and Methods: We retrospectively analyzed 126 patients with post-myocardial infarction (MI) status and 60 control participants who underwent high-resolution Holter electrocardiography. Among the 126 post-MI patients, 23 developed sustained ventricular tachycardia (VT) (the MI-VT group), while 103 did not (the MI-non-VT group) during the observation period. Holter-based LPs were measured at 0:00, 4:00, 8:00, 12:00, 16:00, and 20:00, and heart rate variability analysis was simultaneously performed to investigate factors influencing the diurnal variability in LP parameters. Results: Holter-based LP parameters showed diurnal variation with significant deterioration at night and improvement during the day. Assessment at the time with the longest duration of low-amplitude signals < 40 μV in the filtered QRS complex terminus (LAS40) gave the highest receiver operating characteristics curve (area under the curve, 0.659) and the highest odds ratio (3.75; 95% confidence interval, 1.45–9.71; p = 0.006) for predicting VT. In the multiple regression analysis, heart rate and noise were significant factors affecting the LP parameters in the MI-VT and control groups. In the non-VT group, the LP parameters were significantly influenced by noise and parasympathetic heart rate variability parameters, such as logpNN50. Conclusions: For Holter-based LP measurements, the test accuracy was higher when the LP was measured at the time of the highest or worst value of LAS40. Changes in autonomic nervous system activity, including heart rate, were factors influencing diurnal variability. Increased parasympathetic activity or bradycardia may exacerbate Holter-based LP parameters. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 1648-9144 1010-660X |
| العلاقة: | https://www.mdpi.com/1648-9144/59/8/1460Test; https://doaj.org/toc/1010-660XTest; https://doaj.org/toc/1648-9144Test |
| DOI: | 10.3390/medicina59081460 |
| الوصول الحر: | https://doaj.org/article/7adbe65ae95c437cb17c4054404e53bbTest |
| رقم الانضمام: | edsdoj.7adbe65ae95c437cb17c4054404e53bb |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 16489144 1010660X |
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| DOI: | 10.3390/medicina59081460 |