J Am Coll Cardiol. 1993 Aug;22(2):557-65.  

Comment in:
    J Am Coll Cardiol. 1993 Aug;22(2):566-8.

Conventional heart rate variability analysis of ambulatory electrocardiographic
recordings fails to predict imminent ventricular fibrillation.

Vybiral T, Glaeser DH, Goldberger AL, Rigney DR, Hess KR, Mietus J, Skinner JE,
Francis M, Pratt CM.

Department of Medicine, Baylor College of Medicine, Houston, Texas.

OBJECTIVES. The purpose of this report was to study heart rate variability in
Holter recordings of patients who experienced ventricular fibrillation during
the recording. BACKGROUND. Decreased heart rate variability is recognized as a
long-term predictor of overall and arrhythmic death after myocardial infarction.
It was therefore postulated that heart rate variability would be lowest when
measured immediately before ventricular fibrillation. METHODS. Conventional
indexes of heart rate variability were calculated from Holter recordings of 24
patients with structural heart disease who had ventricular fibrillation during
monitoring. The control group consisted of 19 patients with coronary artery
disease, of comparable age and left ventricular ejection fraction, who had
nonsustained ventricular tachycardia but no ventricular fibrillation. RESULTS.
Heart rate variability did not differ between the two groups, and no consistent
trends in heart rate variability were observed before ventricular fibrillation
occurred. CONCLUSIONS. Although conventional heart rate variability is an
independent long-term predictor of adverse outcome after myocardial infarction,
its clinical utility as a short-term predictor of life-threatening arrhythmias
remains to be elucidated.

PMID: 8335829 [PubMed - indexed for MEDLINE]