University of Oulu

Tulppo MP, Kiviniemi AM, Junttila MJ and Huikuri HV (2019) Home Monitoring of Heart Rate as a Predictor of Imminent Cardiovascular Events. Front. Physiol. 10:341. doi: 10.3389/fphys.2019.00341

Home monitoring of heart rate as a predictor of imminent cardiovascular events

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Author: Tulppo, Mikko P.1; Kiviniemi, Antti M.1; Junttila, M. Juhani1;
Organizations: 1Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
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Language: English
Published: Frontiers Media, 2019
Publish Date: 2020-03-23


Introduction: Previous studies have documented that day-to-day variability of heart rate (HR) has prognostic significance for cardiovascular (CV) events in general population. It is unknown how HR dynamics variate before imminent CV event in patients with coronary artery disease (CAD). Our aim was to study day-to-day variation in HR dynamics before the occurrence of CV event in patients with initially stable CAD.

Methods: Forty-four patients with angiographically documented CAD from ARTEMIS study measured R-R intervals on a weekly basis at home for 2 years. Home measurements were performed in controlled conditions (3 min at supine and sitting) 1–2 times per week. Eleven patients had a CV event (7 acute coronary syndromes, 1 cardiac death, 2 new onset of arrhythmia needing hospitalization and 1 stroke), which occurred 11 ± 7 months after enrolment. Mean R-R interval was analyzed prospectively from the home measurements. For the patients with new CV event, average, and standard deviation (SD) of the mean R-R interval over 8 weeks preceding the CV event were calculated. For the patients without new CV event, corresponding period was determined by the median follow-up at the occurrence of new CV event.

Results: There were no differences in the mean R-R interval analyzed over 8 weeks between the patients with and without new CV event. The variability of mean R-R interval over 8 weeks was greater in the patients with new CV event compared to the patients without new CV event at the supine (95 ± 34 vs. 59 ± 26 ms, p < 0.001) and sitting positions (92 ± 28 vs. 62 ± 24 ms, p < 0.001).

Conclusion: Day-to-day variability of mean R-R interval is greater before the new CV event in CAD patients suggesting to a more unstable cardiac autonomic regulation preceding these events.

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Series: Frontiers in physiology
ISSN: 1664-042X
ISSN-E: 1664-042X
ISSN-L: 1664-042X
Volume: 10
Article number: 341
DOI: 10.3389/fphys.2019.00341
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This work was funded by the Finnish Technology Development Center (TEKES) Helsinki, Finland, the Academy of Finland (#267435), Helsinki, Finland, and the Sigrid Jusélius Foundation, Helsinki, Finland.
Academy of Finland Grant Number: 267435
Detailed Information: 267435 (Academy of Finland Funding decision)
Copyright information: © 2019 Tulppo, Kiviniemi, Junttila and Huikuri. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.