Is the Evaluation of Heart Rate Variability Before ICD Discharge Useful to Understand the Mechanisms of Sudden Cardiac Death?

  • F. Lombardi
  • M. Marzagalli
  • A. De Rosa
  • HRV-ICD Italian Study Group


The role of the autonomic nervous system in facilitating the occurrence of malignant ventricular arrhythmias is supported by several experimental and clinical observations [1]. In different animal models it has been demonstrated that sympathetic activation, particularly during acute myocardial ischemia, may alter cardiac electrical properties and increase electrical instability [1–3]. In the clinical setting, indirect signs of sympathetic activation such an increase in heart rate, are frequently observed in the minutes preceding the onset of ventricular tachycardia or fibrillation [4].


Heart Rate Variability Ventricular Tachycardia Sinus Node Respiratory Sinus Arrhythmia Arrhythmic Event 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Lown B, Verrier RL (1976) Neural activity and ventricular fibrillation. N Engl J Med 294: 1165–1176PubMedCrossRefGoogle Scholar
  2. 2.
    Lombardi F (1986) Acute myocardial ischaemia, neural reflexes and ventricular arrhythmias. Eur Heart J 7: 91–97PubMedGoogle Scholar
  3. 3.
    Schwart PJ, La Rovere MT, Vanoli E (1992) Autonomic nervous system and sudden cardiac death: experimental basis and clinical observations for post-myocardial infarction risk stratification. Circulation 85: 177–191Google Scholar
  4. 4.
    Pantridge JF, Webb SW, Adgey AAY (1981) Arrhythmias in the first hours of acute myocardial infarction. Prog Cardiovasc Dis 23: 265–278PubMedCrossRefGoogle Scholar
  5. 5.
    Roelke M, Garan H, McGovern BA, Ruskin JN (1994) Analysis of the initiation of spontaneous monomorphic ventricular tachycardia by stored intracardiac electrograms. J Am Coll Cardiol 23: 117–122PubMedCrossRefGoogle Scholar
  6. 6.
    Raitt MH, Dolack GL, Kudenchuk PJ, Poole JE, Bardy GH (1995) Ventricular arrhythmias detected after transvenous defibrillator implantation in patients with a clinical history of only ventricular fibrillation. Circulation 91: 1996–2001PubMedCrossRefGoogle Scholar
  7. 7.
    Capucci A, Villani GQ, Sallusti L, Aschieri D, Rosi A on behalf of the ICD-VT Italian Study Group (1996) Insights into ventricular tachycardia onset mechanism from analysis of store ICD electrograms. In: Oto AM (ed) Practice and progress in cardiac pacing and electrophysiology. Kluwer Academic Publishers, Dordrecht, Boston, London pp 347–352CrossRefGoogle Scholar
  8. 8.
    Akselrod S, Gordon D, Ubel FA, Shannon DC, Barger AC, Cohen RJ (1981) Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. Science 213: 220–222PubMedCrossRefGoogle Scholar
  9. 9.
    Pagani M, Lombardi F, Guzzetti S, Rimoldi O. Furlan R, Pizzinelli P, Sandrone G, Malfatto G, Dell’Orto S, Piccaluga E, Turiel M, Baselli G, Cerutti S, Malliani A (1986) Power spectral analysys of heart rate and arterial pressure variabilities as a marker of sympathovagal interaction in man and conscious dog. Circ Res 59: 178–193PubMedCrossRefGoogle Scholar
  10. 10.
    Malliani A, Pagani M, Lombardi F, Cerutti S (1991) Advances research series: cardiovascular neural regulation explored in the frequency domain. Circulation 84: 482–492PubMedCrossRefGoogle Scholar
  11. 11.
    Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Circulation 93: 1043–1065CrossRefGoogle Scholar
  12. 12.
    Lombardi F, Malliani A, Pagani M, Cerutti S (1996) Heart rate variability and its sympatho-vagal modulation. Cardiovasc Res 32: 208–216PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 1998

Authors and Affiliations

  • F. Lombardi
    • 1
  • M. Marzagalli
    • 2
  • A. De Rosa
    • 3
  • HRV-ICD Italian Study Group
  1. 1.Reparto di Cardiologia, Istituto Scienze BiomedicheOspedale S. Paolo, Università di MilanoMilanItaly
  2. 2.Reparto di CardiologiaOspedale S. CarloMilanItaly
  3. 3.MedtronicMilanItaly

Personalised recommendations