Analysis of Heart Rate Variability Before and During Tilt Test in Patients with Cardioinhibitory Vasovagal Syncope
Abstract Background: Cardioinhibitory vasovagal response is uncommon during the tilt test (TT). Heart rate variability (HRV) by use of spectral analysis can distinguish patients with that response. Objective: To compare the HRV in patients with cardioinhibitory vasovagal syncope (case group - G1)...
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Sociedade Brasileira de Cardiologia (SBC)
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| Series: | Arquivos Brasileiros de Cardiologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2016004500568&lng=en&tlng=en |
| _version_ | 1818992171789844480 |
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| author | Cláudia Madeira Miranda Rose Mary Ferreira Lisboa da Silva |
| author_facet | Cláudia Madeira Miranda Rose Mary Ferreira Lisboa da Silva |
| author_sort | Cláudia Madeira Miranda |
| collection | DOAJ |
| description | Abstract Background: Cardioinhibitory vasovagal response is uncommon during the tilt test (TT). Heart rate variability (HRV) by use of spectral analysis can distinguish patients with that response. Objective: To compare the HRV in patients with cardioinhibitory vasovagal syncope (case group - G1) with that in patients without syncope and with negative response to TT (control group - G2). Methods: 64 patients were evaluated (mean age, 36.2 years; 35 men) and submitted to TT at 70 degrees, under digital Holter monitoring. The groups were paired for age and sex (G1, 40 patients; G2, 24). Results: In G1, 21 patients had a type 2A response and 19 had type 2B, with mean TT duration of 20.4 minutes. There was a greater low frequency (LF) component (11,6 versus 4,5 ms2, p=0.001) and a lower low/high frequency ratio in the supine position (3,9 versus 4,5 ms2, p=0.008) in G1, with no difference during TT between the groups. Applying the receiver operating characteristic curve for cardioinhibitory response, the area under the curve was 0.74 for the LF component in the supine position (p = 0.001). The following were observed for the cutoff point of 0.35 ms(2) for the LF component: sensitivity, 97.4%; specificity, 83.3%; positive predictive value, 85.3%; negative predictive value, 96.9%; and positive likelihood ratio, 5.8. Conclusion: HRV in the supine position allowed identifying patients with syncope and cardioinhibitory response with a high negative predictive value and likelihood ratio of 5.8. |
| first_indexed | 2024-12-20T20:21:55Z |
| format | Article |
| id | doaj.art-3f73ae44ee0643d2817ace5cb9209d8c |
| institution | Directory Open Access Journal |
| issn | 1678-4170 |
| language | English |
| last_indexed | 2024-12-20T20:21:55Z |
| publisher | Sociedade Brasileira de Cardiologia (SBC) |
| record_format | Article |
| series | Arquivos Brasileiros de Cardiologia |
| spelling | doaj.art-3f73ae44ee0643d2817ace5cb9209d8c2022-12-21T19:27:33ZengSociedade Brasileira de Cardiologia (SBC)Arquivos Brasileiros de Cardiologia1678-4170107656857510.5935/abc.20160177S0066-782X2016004500568Analysis of Heart Rate Variability Before and During Tilt Test in Patients with Cardioinhibitory Vasovagal SyncopeCláudia Madeira MirandaRose Mary Ferreira Lisboa da SilvaAbstract Background: Cardioinhibitory vasovagal response is uncommon during the tilt test (TT). Heart rate variability (HRV) by use of spectral analysis can distinguish patients with that response. Objective: To compare the HRV in patients with cardioinhibitory vasovagal syncope (case group - G1) with that in patients without syncope and with negative response to TT (control group - G2). Methods: 64 patients were evaluated (mean age, 36.2 years; 35 men) and submitted to TT at 70 degrees, under digital Holter monitoring. The groups were paired for age and sex (G1, 40 patients; G2, 24). Results: In G1, 21 patients had a type 2A response and 19 had type 2B, with mean TT duration of 20.4 minutes. There was a greater low frequency (LF) component (11,6 versus 4,5 ms2, p=0.001) and a lower low/high frequency ratio in the supine position (3,9 versus 4,5 ms2, p=0.008) in G1, with no difference during TT between the groups. Applying the receiver operating characteristic curve for cardioinhibitory response, the area under the curve was 0.74 for the LF component in the supine position (p = 0.001). The following were observed for the cutoff point of 0.35 ms(2) for the LF component: sensitivity, 97.4%; specificity, 83.3%; positive predictive value, 85.3%; negative predictive value, 96.9%; and positive likelihood ratio, 5.8. Conclusion: HRV in the supine position allowed identifying patients with syncope and cardioinhibitory response with a high negative predictive value and likelihood ratio of 5.8.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2016004500568&lng=en&tlng=enFrequência CardíacaSíncope Vasovagal / fisiopatologiaTeste de Mesa InclinadaEletrocardiografia Ambulatorial |
| spellingShingle | Cláudia Madeira Miranda Rose Mary Ferreira Lisboa da Silva Analysis of Heart Rate Variability Before and During Tilt Test in Patients with Cardioinhibitory Vasovagal Syncope Arquivos Brasileiros de Cardiologia Frequência Cardíaca Síncope Vasovagal / fisiopatologia Teste de Mesa Inclinada Eletrocardiografia Ambulatorial |
| title | Analysis of Heart Rate Variability Before and During Tilt Test in Patients with Cardioinhibitory Vasovagal Syncope |
| title_full | Analysis of Heart Rate Variability Before and During Tilt Test in Patients with Cardioinhibitory Vasovagal Syncope |
| title_fullStr | Analysis of Heart Rate Variability Before and During Tilt Test in Patients with Cardioinhibitory Vasovagal Syncope |
| title_full_unstemmed | Analysis of Heart Rate Variability Before and During Tilt Test in Patients with Cardioinhibitory Vasovagal Syncope |
| title_short | Analysis of Heart Rate Variability Before and During Tilt Test in Patients with Cardioinhibitory Vasovagal Syncope |
| title_sort | analysis of heart rate variability before and during tilt test in patients with cardioinhibitory vasovagal syncope |
| topic | Frequência Cardíaca Síncope Vasovagal / fisiopatologia Teste de Mesa Inclinada Eletrocardiografia Ambulatorial |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2016004500568&lng=en&tlng=en |
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