Heart Rate Turbulence After Atrial Premature As A Predictor In Acute Myocardial Infarction

Objective To discuss the prognostic value of heart rate turbulence after atrial premature in acute myocardial infarction(AMI).Method Seventy-six patients with acute myocardial infarction for 1-3 weeks were enrolled and were followed up. The primary endpoints was occurring heart incidents (including myocardial infarction, angina pectoris, malignant arrhythmia and sudden cardiac death), and patients were divided into event group with 20 subjects and non-event group with 56 subjects according to the outcome of following-up. Detailed clinical datas of these subjects were collected, including left ventricular ejection fraction (LVEF), heart rate variability (HRV), mean heart rate, previous myocardial infarction history and heart rate turbulence including turbulence onset (TO) and turbulence slope (TS) after a ventricular premature and an atrial premature. TO and TS after a ventricular premature and an atrial premature was analysised. High-risk factors in prognosis were determined according to previous danger stratifications and survival analysis was made between event group and non-event group in order to assess the prognostic value of heart rate turbulence after atrial premature in acute myocardial infarction(AMI).Results 1 Seventy-six patients were followed up during a follow-up period of (174.1±135.1) days, and patients were divided into event group with 20 subjects and non-event group with 56 subjects according to the outcome of following-up. 2 The value of TSA and TSV in event group were lower than those in non-event group. The phenomenon of heart rate turbulence was significantly attenuated. 3 There was a correlation between left ventricular ejection fraction (LVEF), SDNN, ventricular turbulence slope (TSV), mean heart rate and atrial turbulence slope (TSA). And TOA was not correlation with other prognosis index. 4 In Cox univariate analysis, LVEF, SDNN, history of previous myocardial infarction, TSV, TSA had significant prognosis valves in acute myocardial infarction. In Cox multivariate analysis, LVEF, TSV and TSA were related with heart incident with relative risk end point events of 3.66(P<0.05), 3.88(P<0.01) and 3.23(P<0.05), respectively.Conclusions The value of TSA and TSV in event group were lower than those in non-event group. The phenomenon of heart rate turbulence was significantly attenuated, suggesting that TS was a index in predictiving the acute myocardial infarction. There was a correlation between left ventricular ejection fraction (LVEF), SDNN, ventricular turbulence slope (TSV), mean heart rate and atrial turbulence slope (TSA). And TOA was not correlation with other prognosis index. The phenomenon of heart rate turbulence in event group was significantly attenuated. TSA is a significant and independent predictor of prognosis value in postinfarction patients through Cox univariate analysis and Cox multivariate analysis.