Heart Rate Variability: for real doctors. Regulation in the disease. Some pathological conditions. Acute myocardial infarction

Yabluchansky N.I., Martynenko A.V.

Heart rate variability: for real doctors. Translation from the Russian version of the book, published at Kharkiv, 2010, 131 p.
The basics and practice of the clinical use of the technology of heart rate variability are outlined for doctors of all specialties and students of medical faculties of universities.

9. Regulation in the disease

Some pathological conditions

Acute myocardial infarction. Changes in HRV indicators are most pronounced in the acute period.
The LF / HF ratio can increase to 10 or more with a lower threshold for the occurrence of life-threatening ventricular fibrillation.
With a favorable course of the disease, a gradual increase in the total power of HRV and HF occurs, reflecting the restoration of medium-high-frequency balance.
After a year, HRV returns to normal.
In adverse cases, the evolution of the parameters of HRV delays.
If it takes more than two weeks, the risk of death increases dramatically.
With SD less than 50 ms, it is 5.3 times more than with SD> 100 ms.
LF and HF in the first two weeks of the acute period of myocardial infarction are rigid and do not change even in the orthostatic test.
The situation levels in a year.
The fall in HRV closely correlates with the left ventricular ejection fraction, high-gradation ventricular extrasystoles, and the presence of late ventricular potentials on the averaged ECG.
The use of thrombolytics in case of recanalization favorably affects HRV.
Improvement of HRV in AMI facilitates by taking beta-adrenergic receptor blockers.


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