Visit-to-Visit Heart Rate Variability in the Prediction of Clinical Outcomes of Patients with Atrial Fibrillation
Issued Date
2023-09-01
Resource Type
eISSN
2567689X
Scopus ID
2-s2.0-85168799601
Pubmed ID
37116533
Journal Title
Thrombosis and haemostasis
Volume
123
Issue
9
Start Page
920
End Page
929
Rights Holder(s)
SCOPUS
Bibliographic Citation
Thrombosis and haemostasis Vol.123 No.9 (2023) , 920-929
Suggested Citation
Krittayaphong R., Boonyapisit W., Sairat P., Lip G.Y.H. Visit-to-Visit Heart Rate Variability in the Prediction of Clinical Outcomes of Patients with Atrial Fibrillation. Thrombosis and haemostasis Vol.123 No.9 (2023) , 920-929. 929. doi:10.1055/s-0043-1768580 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/89287
Title
Visit-to-Visit Heart Rate Variability in the Prediction of Clinical Outcomes of Patients with Atrial Fibrillation
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
BACKGROUND: Visit-to-visit heart rate variability (VVV-HR) has been associated with adverse cardiovascular outcomes. We aimed to determine the predictive value of VVV-HR for adverse clinical outcomes in patients with nonvalvular atrial fibrillation (AF). METHODS: We used data from a prospective multicenter AF registry of 27 hospitals in Thailand during 2014 to 2017. After the baseline visit, patients were followed up every 6 months until 3 years. VVV-HR was calculated from the standard deviation of heart rate data from baseline visit and every follow-up visit. VVV-HR was categorized into four groups according to the quartiles. Clinical outcomes were all-cause death, ischemic stroke/systemic embolism (SE), and heart failure. Cox proportional hazard models were used for multivariable analysis. RESULTS: There were a total of 3,174 patients (mean age: 67.7 years; 41.8% female). The incidence rates of all-cause death, ischemic stroke/SE, and heart failure were 3.10 (2.74-3.49), 1.42 (1.18-1.69), and 2.09 (1.80-2.42) per 100 person-years respectively. The average heart rate was 77.8 ± 11.0 bpm and the average of standard deviation of heart rate was 11.0 ± 5.9 bpm. VVV-HR Q4 was an independent predictor of all-cause death, ischemic stroke/SE, and heart failure with adjusted hazard ratios of 1.45 (95% confidence interval: 1.07-1.98), 2.02 (1.24-3.29), and 2.63 (1.75-3.96), respectively. VVV-HR still remained a significant predictor of clinical outcomes when analyzed based on coefficient of variation and variability independent of mean. CONCLUSION: VVV-HR is an independent predictor for adverse clinical outcomes in patients with AF. A J-curve appearance was demonstrated for the effect of VVV-HR on all-cause death.