LONG-RANGE FRACTAL SCALING PROPERTIES OF HEART RATE DYNAMICS PREDICTS LONG-TERM SURVIVAL IN PATIENTS WITH CHRONIC ATRIAL FIBRILLATION

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Background-Fractal scaling property of heart rate dynamics predicts risk of death in cardiac patients with sinus rhythm (SR). We previously observed that long-term fluctuation of heart rate in chronic atrial fibrillation (AF) shows 1/f scaling characteristics similar to those ob-served in SR. In this study, we examined if long-range fractal scaling property has prognostic value in patients with chronic AF. Methods and Results-We studied 117 patients with chronic AF who underwent ambulatory ECG between 1993 and 1997. We evaluated long-range (>10^3 beats) fractal correlation of nighttime and whole-day heart rate dynamics using α index of detrended fluctuation analysis. During an observational period of 57±25 months, 37 patients died included 23 cardiac deaths. Patients who died from cardiac causes compared with those who survived showed a higher α for nighttime heart rate dynamics (1.15±0.20 vs 1.02±0.23, P<0.01) . No such difference was observed for whole-day dynamics (1.17±0.09 vs 1.20±0.09) . Among clinical variables, significant associations with cardiac death were observed for age, body mass index, New York Heart Association functional class, and ejection fraction. Even after adjustment for these clinical variables, α during nighttime was an independent predictor of cardiac death (relative risk, 2.60; 95% confidence interval, 1.45 to 4.67, per 1-SD increment). No such predictive power was observed for noncardiac death. Conclusions-Long-range fractal scaling property (increased level of temporal correlation) of nighttime heart rate dynamics is an increased risk for cardiac death in patients with chronic AF.
名古屋市立大学の論文
2007-01-31

LONG-RANGE FRACTAL SCALING PROPERTIES OF HEART RATE DYNAMICS PREDICTS LONG-TERM SURVIVAL IN PATIENTS WITH CHRONIC ATRIAL FIBRILLATION

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