Restoration of heart rate turbulence by titrated beta-blocker therapy in patients with advanced congestive heart failure: Positive correlation with enhanced vagal modulation of heart rate

Lian Yu Lin, Juey Jen Hwang, Ling Ping Lai, Hsiao Lung Chan, Chao Cheng Du, Yung Zu Tseng, Jiunn Lee Lin

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Introduction: Heart rate turbulence (HRT) is a powerful novel predictor for cardiovascular mortality. Chronic congestive heart failure is associated with abnormal HRT. Whether antiadrenergic beta-blocker therapy can restore control of HRT in patients with chronic congestive heart failure is unknown. Methods and Results: A 24-hour Holter ECG recording was obtained before and 1 and 3 months after titrated addition of atenolol therapy in 10 consecutive patients with advanced congestive heart failure. Two parameters derived from HRT, turbulence slope (TS) and turbulence onset (TO), and time- and frequency-domain heart rate variability (HRV) parameters (SDNN, RMSSD, VLF, LF, HF) from 24-hour ECG were compared before and after beta-blocker therapy, together with the same parameters in age-matched normal control. Results showed that TS (3.1 ± 2.2 vs 6.2 ± 3.0; P = 0.001) and all HRV parameters were increased after 3 months of atenolol treatment. No changes in TO were evident (0.6 ± 0.5 vs -0.2 ± 1.3; P = 0.13). The improvement of TS and the vagally mediated parameters of mean R-R interval, RMSSD, and the HF component of HRV were positively correlated. Conclusion: Abnormal HRT caused by chronic congestive heart failure can be restored by beta-blocker therapy. The evolution of TS was positively correlated with measures of vagal modulation of heart rate.

Original languageEnglish
Pages (from-to)752-756
Number of pages5
JournalJournal of Cardiovascular Electrophysiology
Volume15
Issue number7
DOIs
Publication statusPublished - Jul 1 2004
Externally publishedYes

Keywords

  • Beta-blocker
  • Congestive heart failure
  • Heart rate turbulence
  • Heart rate variability

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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