Multiscale Entropy of the Heart Rate Variability for the Prediction of an Ischemic Stroke in Patients with Permanent Atrial Fibrillation

نویسندگان

  • Eiichi Watanabe
  • Ken Kiyono
  • Junichiro Hayano
  • Yoshiharu Yamamoto
  • Joji Inamasu
  • Mayumi Yamamoto
  • Tomohide Ichikawa
  • Yoshihiro Sobue
  • Masehide Harada
  • Yukio Ozaki
  • Vincenzo Lionetti
چکیده

BACKGROUND Atrial fibrillation (AF) is a significant risk factor for ischemic strokes, and making a robust risk stratification scheme would be important. Few studies have examined whether nonlinear dynamics of the heart rate could predict ischemic strokes in AF. We examined whether a novel complexity measurement of the heart rate variability called multiscale entropy (MSE) was a useful risk stratification measure of ischemic strokes in patients with permanent AF. METHODS AND RESULTS We examined 173 consecutive patients (age 69 ± 11 years) with permanent AF who underwent 24-hour Holter electrocardiography from April 2005 to December 2006. We assessed several frequency ranges of the MSE and CHA2DS2-VASc score (1 point for congestive heart failure, hypertension, diabetes, vascular disease, an age 65 to 74 years, and a female sex and 2 points for an age ≥ 75 years and a stroke or transient ischemic attack). We found 22 (13%) incident ischemic strokes during a mean follow up of 3.8-years. The average value of the MSE in the very-low frequency subrange (90-300 s, MeanEnVLF2) was significantly higher in patients who developed ischemic strokes than in those who did not (0.68 ± 0.15 vs. 0.60±0.14, P<0.01). There was no significant difference in the C-statistic between the CHA2DS2-VASc score and MeanEnVLF2 (0.56; 95% confidence interval, 0.43-0.69 vs. 0.66; 95% confidence interval, 0.53-0.79). After an adjustment for the age, CHA2DS2-VASc score, and antithrombotic agent, a Cox hazard regression model revealed that the MeanEnVLF2 was an independent predictor of an ischemic stroke (hazard ratio per 1-SD increment, 1.80; 95% confidence interval, 1.17-2.07, P<0.01). CONCLUSION The MeanEnVLF2 in 24-hour Holter electrocardiography is a useful risk stratification measure of ischemic strokes during the long-term follow-up in patients with permanent AF.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Association between Multiscale Entropy Characteristics of Heart Rate Variability and Ischemic Stroke Risk in Patients with Permanent Atrial Fibrillation

Multiscale entropy (MSE) profiles of heart rate variability (HRV) in patients with atrial fibrillation (AFib) provides clinically useful information for ischemic stroke risk assessment, suggesting that the complex properties characterized by MSE profiles are associated with ischemic stroke risk. However, the meaning of HRV complexity in patients with AFib has not been clearly interpreted, and t...

متن کامل

Scattering Transform of Heart Rate Variability for the Prediction of Ischemic Stroke in Patients with Atrial Fibrillation

Atrial fibrillation is an identified risk factor for ischemic strokes. Thus, the dynamics of heart rate under fibrillation might provide a useful predictor for strokes. The complex, nonlinear and multiscale nature of the heart rate calls for the use of powerful signal processing techniques. We explored the application of a novel tool, the scattering transform, to discriminate and predict ischem...

متن کامل

Evaluation of transesophageal echocardiography in detecting cardiac sources of emboli in ischemic stroke patients

  Background: Embolus is one of the causes of ischemic stroke that can be due to cardiac sources such as valvular heart diseases and atrial fibrillation and atheroma of the aorta. Transesophageal echocardiography (TEE) is superior in identifying potential cardiac sources of emboli. Due to insufficient data on TEE findings in ischemic stroke in Iran, the present study was done to evaluate TEE in...

متن کامل

The Prevalence of Prescription of New Anticoagulant Drugs and Its Determinant Factors in Patients With Ischemic Stroke and Non-valvular Atrial Fibrillation

Background: Patients with ischemic stroke and underlying Atrial Fibrillation (AF) have a high risk of recurrent embolic events. New Oral Anticoagulant (NOAC) is highly effective and reduces the risk of recurrence in AF-associated Ischemic Stroke (AFAIS). Objectives: This study aimed to determine the prescription pattern of NOAC and its determinant factors in patients with non-valvular AFAIS. ...

متن کامل

Clinical Significance of P Wave Dispersion in Prediction of Atrial Fibrillation in Patients with Acute Myocardial Infarction

Background: P wave dispersion (PWD) is defined as the difference between the maximum P wave duration (Pmax) and the minimum P wave duration (Pmin) in 12-leads of the surface electrocardiography. The aim of this study was to evaluate the values of PWD during atrial fibrillation (AF) after acute myocardial infarction (AMI). Methods: We prospectively evaluated atrial rhythms of 350 patients (251 m...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 10  شماره 

صفحات  -

تاریخ انتشار 2015