Risk Stratification After Acute Myocardial Infarction by Heart Rate Turbulence

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Abstract
Background— Retrospective postinfarction studies revealed that decreased heart rate turbulence (HRT) indicates increased risk for subsequent death. This is the first prospective study to validate HRT in a large cohort of the reperfusion era. Methods and Results— One thousand four hundred fifty-five survivors of an acute myocardial infarction (age 30%, age ≥65 years, diabetes mellitus, and HRT category 2 had a sensitivity of 24% at a positive predictive accuracy level of 37%. The combined criteria of LVEF ≤30% or LVEF >30%, age ≥65 years, diabetes mellitus, and HRT category 1 or 2 had a sensitivity of 44% at a positive predictive accuracy level of 23%. Conclusions— HRT is a strong predictor of subsequent death in postinfarction patients of the reperfusion era.