Heart Rate Variability: for real doctors. Regulation in the disease. Some pathological conditions. Heart transplantation

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

Heart transplantation. The HRV technology makes it possible to determine in advance the onset of cardiac reanimation after transplantation.
In solving this problem, HF HRV is of no practical interest due to its modulation with breathing.
HF HRV reflects direct non-cardiac effects on the heart rhythm and is determined by the state of the nervous regulation.
As early as 20 months after transplantation, more than half of the observations revealed low-frequency oscillations of the heart rhythm.
The power of these oscillations is almost an order of magnitude smaller than that of healthy ones.
Inhalation of amyl nitrate, which is associated with a drop in blood pressure, leads to their decrease and reflects a connection with sympathetic effects on the heart.
Heart transplantation in patients with heart failure in the immediate postoperative period does not contribute to an increase in HRV, despite the restoration of blood circulation adequate to the demands of the organism.
Full reinnervation of the heart is not restored even 8 years after transplantation.
When heart transplantation is accompanied by implantation of an external pacemaker, changes in HRV are complemented by a fall and its HF component.


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