Ultra-short-term heart rate variability for early risk stratification following acute st-elevation myocardial infarction

Erez Karp, Arthur Shiyovich, Doron Zahger, Harel Gilutz, Aviva Grosbard, Amos Katz

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Objectives: To evaluate the prognostic significance of early ultra-short-term heart rate variability (HRV) measurement in patients admitted for ST-elevation myocardial infarction (STEMI). Methods: HRV was calculated retrospectively from the standard admission and discharge 10-second ECG of 196 consecutive patients with STEMI. Reduced HRV was defined as standard deviation of N-N intervals (SDNN) <9.5 (25th percentile). Data regarding all end points were obtained 2 years after discharge for all patients. Results: Patients' age was 60.9 ± 13 years and 21% were female. Admission SDNN was lower than discharge SDNN (20.2 ± 18 vs. 34.2 ± 31.1, respectively; p = 0.001). Admission and discharge SDNN positively correlated with survival (r = 0.16, p = 0.03 and r = 0.15, p = 0.04, respectively), but were not predictive of other cardiovascular end points. Reduced admission SDNN was associated with increased mortality at 1 and 6 months, and 1 and 2 years after admission, while discharge SDNN was associated only with 1- and 2-year mortality. Using multivariate analysis, adjusted for potential confounders, admission SDNN <9.5 was found to be an independent risk factor for 2-year mortality (odds ratio = 2.9, 95% confidence interval = 1.12-7.56; p = 0.028). Conclusions: Reduced HRV, recorded from admission and discharge ECG, appears to be a significant and independent predictor of all-cause mortality in patients with STEMI.

Original languageEnglish
Pages (from-to)275-283
Number of pages9
Issue number4
StatePublished - 1 Oct 2009


  • Heart rate variability
  • Mortality
  • Myocardial infarction
  • Risk stratification
  • ST elevation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)


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