Predictive Value of Heart Rate Variability Analysis in the Diagnosis of Fatal Arrhythmias in Patients with Acute Myocardial Infarction
Despite constantly improving approaches to diagnosis and treatment of acute myocardial infarction, there still remains the relevance for risk stratification of adverse effects of this disease. It is known that in patients with acute coronary syndrome in the first hours of the onset of the disease is quite often recorded ventricular arrhythmias that may be predictive of sudden death. One of the informative methods for prediction of fatal ventricular arrhythmias in patients with acute myocardial infarction is ECG monitoring, with an analysis of heart rate variability (HRV), ventricular late potentials and the dispersion of the interval QT. At the present stage development of new mathematical methods and algorithms for processing biological signals, as well as clinical results allowed determine the role of HRV analysis in cardiology in predicting the development of premorbid states and even the likelihood of sudden death. HRV change is a consequence of an imbalance of sympathetic and parasympathetic regulation of cardiac activity, substrate for myocardial electrical instability and the occurrence of fatal arrhythmias. Thus, the method of HRV can be actively used to identify patients at high risk of fatal arrhythmias against acute myocardial infarction. But to date, there are problems associated with the evaluation of sensitivity, specificity and prognostic power of this method with respect to the prediction of sudden cardiac death and evaluation of electrical instability of the heart.