Review|Volume 10, Issue 2|pp 166—177

Heart rate variability as predictive factor for sudden cardiac death

Francesco Sessa¹, Valenzano Anna¹, Giovanni Messina¹, Giuseppe Cibelli¹, Vincenzo Monda², Gabriella Marsala³, Maria Ruberto⁴, Antonio Biondi⁵, Orazio Cascio⁶, Giuseppe Bertozzi¹, Daniela Pisanelli¹, Francesca Maglietta¹, Antonietta Messina², Maria P. Mollica², Monica Salerno¹

¹University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
²Università degli Studi di Napoli Federico II, Department of Experimental Medicine, Naples, Italy
³Struttura Complessa di Farmacia, Azienda Ospedaliero-Universitaria, Foggia, Italy
⁴CRD Center, Santa Maria del Pozzo, Somma Vesuviana (NA), Italy
⁵University of Catania, Department of Surgery, Catania, Italy
⁶University of Catania, Department of Anatomy, Catania, Italy

* * Equal contribution

Received: December 27, 2017Accepted: February 9, 2018Published: February 23, 2018

https://doi.org/10.18632/aging.101386

Copyright: © 2018 Sessa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Sudden cardiac death (SCD) represents about 25% of deaths in clinical cardiology. The identification of risk factors for SCD is the philosopher's stone of cardiology and the identification of non-invasive markers of risk of SCD remains one of the most important goals for the scientific community.

The aim of this review is to analyze the state of the art around the heart rate variability (HRV) as a predictor factor for SCD.

HRV is probably the most analyzed index in cardiovascular risk stratification technical literature, therefore an important number of models and methods have been developed.

Nowadays, low HRV has been shown to be independently predictive of increased mortality in post- myocardial infarction patients, heart failure patients, in contrast with the data of the general population.

Contrariwise, the relationship between HRV and SCD has received scarce attention in low-risk cohorts. Furthermore, in general population the attributable risk is modest and the cost/benefit ratio is not always convenient.

The HRV evaluation could become an important tool for health status in risks population, even though the use of HRV alone for risk stratification of SCD is limited and further studies are needed.