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Interval Variability (interval + variability)

Distribution by Scientific Domains

Medical Sciences	83%

Kinds of Interval Variability

qt interval variability

Selected Abstracts

QT Interval Variability and Adaptation to Heart Rate Changes in Patients with Long QT Syndrome

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 1 2009
JAN N, MEC M.D.
Background: Increased QT variability (QTV) has been reported in conditions associated with ventricular arrhythmias. Data on QTV in patients with congenital long QT syndrome (LQTS) are limited. Methods: Ambulatory electrocardiogram recordings were analyzed in 23 genotyped LQTS patients and in 16 healthy subjects (C). Short-term QTV was compared between C and LQTS. The dependence of QT duration on heart rate was evaluated with three different linear models, based either on the RR interval preceding the QT interval (RR0), the RR interval preceding RR0 (RR -1), or the average RR interval in the 60-second period before QT interval (mRR). Results: Short-term QTV was significantly higher in LQTS than in C subjects (14.94 ± 9.33 vs 7.31 ± 1.29 ms; P < 0.001). It was also higher in the non-LQT1 than in LQT1 patients (23.00 ± 9.05 vs 8.74 ± 1.56 ms; P < 0.001) and correlated positively with QTc in LQTS (r = 0.623, P < 0.002). In the C subjects, the linear model based on mRR predicted QT duration significantly better than models based on RR0 and RR -1. It also provided better fit than any nonlinear model based on RR0. This was also true for LQT1 patients. For non-LQT1 patients, all models provided poor prediction of QT interval. Conclusions: QTV is elevated in LQTS patients and is correlated with QTc in LQTS. Significant differences with respect to QTV exist among different genotypes. QT interval duration is strongly affected by noninstantaneous heart rate in both C and LQT1 subjects. These findings could improve formulas for QT interval correction and provide insight on cellular mechanisms of QT adaptation. [source]

Sodium Channel Blockers Enhance the Temporal QT Interval Variability in the Right Precordial Leads in Brugada Syndrome

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 1 2008
Tetsuzou Kanemori M.D.
Background: Temporal QT interval variability is associated with sudden cardiac death. The purpose of this study was to evaluate temporal QT interval variability in Brugada syndrome (BS). Methods: We measured QT and RR intervals in precordial leads (V1,V6) based on 12-beat resting ECG recordings from 16 BS patients (B group) with spontaneous ST elevation in right precordial leads (V1,V2) and from 10 patients with normal hearts (C group). We measured the response in B group before and after administration of pilsicainide (1 mg/kg). The standard deviation (QT-SD, RR-SD) of the time domain and total frequency power (QT-TP, RR-TP) were calculated for all precordial leads, and the latter was to analyze the frequency domain. Results: The right precordial leads in BS exhibited an additional and prominent ST elevation (coved-type) after pilsicainide administration. Both QT-SD and QT-TP values were significantly more increased in B, than in C (5.1 ± 1.2 vs 3.6 ± 0.2 and 23.4 ± 2.9 vs 12.3 ± 1.7 msec2, P < 0.01, respectively) and after pilsicainide administration in B. (5.1 ± 0.4 vs 3.9 ± 0.3, 25.8 ± 3.4 vs 16.3 ± 2.6 msec2, P < 0.01, respectively) However, QT-SD and QT-TP did not significantly change in any of other leads (V3,V6) and RR-SD and RR-TP were similar for both groups, as well as after intravenous pilsicainide administration in B. Conclusions: The temporal QT interval variability was identified in BS. Moreover, sodium channel blocker induced temporal fluctuation in QT interval and it may possibly provide a substrate for ventricular arrhythmia in BS patients. [source]

Coronary MR angiography at 3T during diastole and systole

JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 4 2007
Ahmed M. Gharib MD
Abstract Purpose To investigate the impact of end-systolic imaging on quality of right coronary magnetic resonance angiography (MRA) in comparison to diastolic and to study the effect of RR interval variability on image quality. Materials and Methods The right coronary artery (RCA) of 10 normal volunteers was imaged at 3T using parallel imaging (sensitivity encoding [SENSE]). Navigator-gated three-dimensional (3D) gradient echo was used three times: 1) end-systolic short acquisition (SS): 35-msec window; 2) diastolic short (DS): middiastolic acquisition using 35-msec window; and 3) diastolic long (DL): 75-msec diastolic acquisition window. Vectorcardiogram (VCG) data was used to analyze RR variability. Vessel sharpness, length, and diameter were compared to each other and correlated with RR variability. Blinded qualitative image scores of the images were compared. Results Quantitative and qualitative parameters were not significantly different and showed no significant correlation with RR variability. Conclusion Imaging the RCA at 3T during the end-systolic rest period using SENSE is possible without significant detrimental effect on image quality. Breaking away from the standard of imaging only during diastole can potentially improve image quality in tachycardic patients or used for simultaneous imaging during both periods in a single scan. J. Magn. Reson. Imaging 2007;26:921,926. © 2007 Wiley-Liss, Inc. [source]

Variability in Postpacing Intervals Predicts Global Ventricular Activation Pattern during Tachycardia

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 2 2010
ILYAS K. COLOMBOWALA M.D.
Introduction: Assessment of ventricular activation pattern is critical to the successful ablation of ventricular tachycardia (VT). We have previously shown that the global atrial activation pattern during tachycardia can be rapidly and accurately assessed by calculating the postpacing interval variability (PPIV); PPIV was minimal in circuitous tachycardias and highly variable in centrifugal tachycardias. In the present study, we use the PPIV to determine the ventricular global activation pattern during VT. Methods: Patients with mappable VT were included. We defined global ventricular activation as either centrifugal (arising from a focus with radial expansion) or circuitous (gross macro-reentrant circuit), based on the findings of electroanatomic mapping. PPIV was calculated as the difference in postpacing interval with right ventricular apical overdrive pacing during tachycardia at cycle lengths (CL) 10 ms and 30-ms shorter than tachycardia, regardless of the origin of the tachycardia. We studied 20 patients with 23 VTs (11 centrifugal, mean CL 390 ± 36.1 ms; 12 circuitous, mean CL 418 ± 75.7 ms). Results: The mean PPIV was 45 ± 16 ms for patients with centrifugal VT and 6.7 ± 4.1 ms for patients with circuitous VT. Rank sum analysis of PPIV showed a significant difference between the two groups (P < 0.05). Conclusions: Our data suggest that the global ventricular activation pattern during VT can be rapidly and accurately defined by assessing the PPIV. This technique allows for a rapid confirmation of the tachycardia activation and significantly facilitates mapping and ablation. (PACE 2010; 33:129,134) [source]

The impact of menstrual cycle phase on cardiac autonomic regulation

PSYCHOPHYSIOLOGY, Issue 4 2009
Paula S. Mckinley
Abstract This study investigated menstrual cycle phase differences in heart rate (HR) and RR interval variability (RRV) in 49 healthy, premenopausal, eumenorrheic women (age 30.2±6.2 years). HR and RRV were computed from ambulatory 24-h electrocardiogram, collected for up to 6 days, with at least 1 day each during early to midfollicular and midluteal menstrual phases. Phase effects on HR and RRV were assessed using linear mixed effects models with a random intercept to account for the correlation of observations within each subject as well as intrasubject variation. During follicular phase monitoring, women had significantly lower average HR (,2.33 bpm), and higher standard deviation, the root mean squared successive difference, and high frequency (0.04,0.15 Hz) and low frequency (0.15,0.40 Hz) RRV than during the luteal phase. These results provide strong support for the influence of menstrual phase on cardiac autonomic regulation in premenopausal women. [source]

Fluctuations in isometric muscle force can be described by one linear projection of low-frequency components of motor unit discharge rates

THE JOURNAL OF PHYSIOLOGY, Issue 24 2009
Francesco Negro
The aim of the study was to investigate the relation between linear transformations of motor unit discharge rates and muscle force. Intramuscular (wire electrodes) and high-density surface EMG (13 × 5 electrode grid) were recorded from the abductor digiti minimi muscle of eight healthy men during 60 s contractions at 5%, 7.5% and 10% of the maximal force. Spike trains of a total of 222 motor units were identified from the EMG recordings with decomposition algorithms. Principal component analysis of the smoothed motor unit discharge rates indicated that one component (first common component, FCC) described 44.2 ± 7.5% of the total variability of the smoothed discharge rates when computed over the entire contraction interval and 64.3 ± 10.2% of the variability when computed over 5 s intervals. When the FCC was computed from four or more motor units per contraction, it correlated with the force produced by the muscle (62.7 ± 10.1%) by a greater degree (P < 0.001) than the smoothed discharge rates of individual motor units (41.4 ± 7.8%). The correlation between FCC and the force signal increased up to 71.8 ± 13.1% when the duration and the shape of the smoothing window for discharge rates were similar to the average motor unit twitch force. Moreover, the coefficients of variation (CoV) for the force and for the FCC signal were correlated in all subjects (R2 range = 0.14,0.56; P < 0.05) whereas the CoV for force was correlated to the interspike interval variability in only one subject (R2= 0.12; P < 0.05). Similar results were further obtained from measures on the tibialis anterior muscle of an additional eight subjects during contractions at forces up to 20% of the maximal force (e.g. FCC explained 59.8 ± 11.0% of variability of the smoothed discharge rates). In conclusion, one signal captures most of the underlying variability of the low-frequency components of motor unit discharge rates and explains large part of the fluctuations in the motor output during isometric contractions. [source]

Left Ventricular Mass Is Associated With Ventricular Repolarization Heterogeneity One Year After Renal Transplantation

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 2 2008
M. Arnol
Ventricular repolarization heterogeneity (VRH) is associated with the risk of arrhythmia and cardiac death. This study investigated the association between VRH and left ventricular mass (LVM) in renal transplant recipients 1 year after transplantation. Echocardiography and 5-min 12-lead electrocardiogram were recorded and GFR was estimated (eGFR) in 68 nondiabetic patients. Beat-to-beat QT interval variability algorithm was used to calculate SDNN-QT and rMSSD-QT indices of VRH. To quantify QT interval variability relative to heart rate fluctuations, QTRR index was calculated. Left ventricular hypertrophy (LVH) was present in 44 patients (65%). LVM and incidence of LVH were increased in 28 patients with eGFR <60 mL/min/1.73 m2 compared with 40 patients with eGFR ,60 mL/min/1.73 m2 (248 ± 61 g and 86% vs. 210 ± 46 g and 50%, respectively; p < 0.01). A direct correlation was found between LVM and SDNN-QT (R = 0.47, R2= 0.23; p < 0.001), rMSSD-QT (R = 0.27; R2= 0.10; p = 0.034), and QTRR (R = 0.55; R2= 0.31; p < 0.001) indices. In conclusion, greater LVM is associated with increased VRH in renal transplant recipients, providing a link with the high risk of arrhythmia and cardiac death, specifically in patients with decreased graft function. [source]

Influence of Age on Linear and Nonlinear Measures of Autonomic Cardiovascular Modulation

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2 2010
Michael K. Boettger M.D.
Background: Age has been identified as an independent risk factor for cardiovascular diseases. In addition, autonomic imbalance toward sympathetic preponderance has been shown to facilitate the occurrence of heart disease. Here, we aimed to assess autonomic modulation of cardiovascular parameters during normal ageing applying well-established linear and novel nonlinear parameters. Methods: Linear and nonlinear measures of heart rate variability and complexity as well as measures of QT interval variability and baroreflex sensitivity were obtained from a total of 131 healthy, medication-free participants from a continuous age range between 20 and 90 years, who were allocated to three different age groups. Results: Heart rate variability and complexity significantly decreased with age, while regularity of heart rate time series increased. In addition, QT interval variability linearly increased with age, while baroreflex sensitivity showed a pronounced decrease. Overall, concerning effects of ageing, linear and nonlinear parameters showed equal differentiation between groups. Conclusion: These data indicate a shift of autonomic balance toward sympathetic predominance in higher age groups, limiting the reactiveness of the cardiovascular system to adjust to different demands and increasing the risk for developing tachyarrhythmias. Ann Noninvasive Electrocardiol 2010;15(2):165,174 [source]

Beat-to-Beat QT Interval Variability Is Primarily Affected by the Autonomic Nervous System

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 3 2008
Ph.D., Takanao Mine M.D.
Background: Beat-to-beat QT interval variability is associated with life-threatening arrhythmias and sudden death, however, its precious mechanism and the autonomic modulation on it remains unclear. The purpose of this study was to determine the effect of drugs that modulate the autonomic nervous system on beat-to-beat QT interval. Method: RR and QT intervals were determined for 512 consecutive beats during fixed atrial pacing with and without propranolol and automatic blockade (propranolol plus atropine) in 11 patients without structural heart disease. Studied parameters included: RR, QTpeak (QRS onset to the peak of T wave), QTend (QRS onset to the end of T wave) interval, standard deviation (SD) of the RR, QTpeak, and QTend (RR-SD, QTpeak-SD, and QTend-SD), coefficients of variation (RR- CV, QTpeak-CV, and QTend-CV) from time domain analysis, total power (TP; RR-TP, QTpeak-TP, and QTend-TP), and power spectral density of the low-frequency band (LF; RR-LF, QTpeak-LF, and QTend-LF) and the high-frequency band (HF; RR-HF, QTpeak-HF and QTend-HF). Results: Administration of propranolol and infusion of atropine resulted in the reduction of SD, CV, TP, and HF of the QTend interval when compared to controlled atrial pacing (3.7 ± 0.6 and 3.5 ± 0.5 vs 4.8 ± 1.4 ms, 0.9 ± 0.1 and 0.9 ± 0.1 vs 1.2 ± 0.3%, 7.0 ± 2.2 and 7.0 ± 2.2 vs 13.4 ± 8.1 ms2, 4.2 ± 1.4 and 4.2 ± 1.2 vs 8.4 ± 4.9 ms2, respectively). Administration of propranolol and atropine did not affect RR interval or QTpeak interval indices during controlled atrial pacing. Conclusions: Beat-to-beat QT interval variability is affected by drugs that modulate the autonomic nervous system. [source]

Sodium Channel Blockers Enhance the Temporal QT Interval Variability in the Right Precordial Leads in Brugada Syndrome

R-Wave Detection by Subcutaneous ECG.

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 1 2001
Possible Use for Analyzing R-R Variability
Background: Atrial arrhythmia (AA) discrimination remains a technological challenge for implanted cardiac devices. We examined the feasibility of R-wave detection by a subcutaneous far field ECG (SFFECG) and analysis of these signals for R to R variability as an indicator of atrial arrhythmia (AA). Methods: Surface ECG and SFFECG (from the pacemaker pocket) were recorded in sixteen patients (61.5 ± 11.4 years) with AA. The SFFECG was recorded with a pacemaker sized four electrode array acutely placed in the pacemaker pocket during implantation. The signals were analyzed to obtain peak-to-peak R wave amplitude and R to R interval variability (indicative of AAs). Results: In sixteen patients R waves were visually discernible in all recordings. The percentage over and under detection for automatic R wave recognition SFFECG was 3 and 9%, respectively. R to R variability analysis using the SFFECG produced results concordant to those using the surface ECG. Conclusion: SFFECG might be a helpful adjunct in implantable device systems for detection of R waves and may be used for measurement of R to R variability. A.N.E. 2001;6(1):18,23 [source]

Decrease in heart rate variability with overtraining: assessment by the Poincaré plot analysis

CLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 1 2004
Laurent Mourot
Summary Numerous symptoms have been associated with the overtraining syndrome (OT), including changes in autonomic function. Heart rate variability (HRV) provides non-invasive data about the autonomic regulation of heart rate in real-life conditions. The aims of the study were to: (i) characterize the HRV profile of seven athletes (OA) diagnosed as suffering of OT, compared with eight healthy sedentary (C) and eight trained (T) subjects during supine rest and 60° upright, and (ii) compare the traditional time- and frequency-domain analysis assessment of HRV with the non-linear Poincaré plot analysis. In the latter each R-R interval is plotted as a function of the previous one, and the standard deviations of the instantaneous (SD1) and long-term R-R interval variability are calculated. Total power was higher in T than in C and OA both in supine (1158 ± 1137, 6092 ± 3554 and 2970 ± 2947 ms2 for C, T and OA, respectively) and in upright (640 ± 499, 1814 ± 806 and 1092 ± 712 ms2 for C, T and OA, respectively; P<0·05) positions. In supine position, indicators of parasympathetic activity to the sinus node were higher in T compared with C and OA (high-frequency power: 419·1 ± 381·2, 1105·3 ± 781·4 and 463·7 ± 715·8 ms2 for C, T and OA, respectively; P<0·05; SD1: 29·5 ± 18·5, 75·2 ± 17·2 and 37·6 ± 27·5 for C, T and OA, respectively; P<0·05). OA had a marked predominance of sympathetic activity regardless of the position (LF/HF were 0·47 ± 0·35, 0·47 ± 0·50 and 3·96 ± 5·71 in supine position for C, T and OA, respectively, and 2·09 ± 2·17, 7·22 ± 6·82 and 12·04 ± 10·36 in upright position for C, T and OA, respectively). The changes in HRV indexes induced by the upright posture were greater in T than in OA. The shape of the Poincaré plots allowed the distinction between the three groups, with wide and narrow shapes in T and OA, respectively, compared with C. As Poincaré plot parameters are easy to compute and associated with the ,width' of the scatter gram, they corroborate the traditional time- and frequency-domain analysis. We suggest that they could be used to indicate fatigue and/or prevent OT. [source]