Heart Rate Turbulence

 

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International Society for Holter and Noninvasive Electrocardiology
 

Table of content

ISHNE Consensus Document

Risk Prediction

HRT in miscellaneous diseases

Role of HRT in prediction of atrial fibrillation

Response to drugs

HRT in the healthy

Mechanism of HRT

Technical aspects

Other VPC-triggered turbulences

Letters

Editorials

Review Articles


ISHNE Consensus Document[Up]

Axel Bauer, Marek Malik, Georg Schmidt, Petra Barthel, Hendrik Bonnemeier, Iwona Cygankiewicz, Przemyslaw Guzik, Federico Lombardi, Alexander Mueller, Ali Oto, Raphael Schneider, Mari Watanabe, Dan Wichterle, Wojciech Zareba
Heart Rate Turbulence: Standards of Measurement,Physiological Interpretation, and Clinical Use
Journal of the American College of Cardiology; Vol. 52, No. 17, 2008:1353 - 65


Risk Prediction - Post-infarction phase [Up]

Schmidt G, Malik M, Barthel P, Schneider R, Ulm K, Rolnitzky L, Camm AJ, Bigger Jr. JT, Schömig A.
Heart-rate turbulence after ventricular premature beats as a predictor of mortality after acute myocardial infarction.
Lancet 1999; Vol. 353; No. 9162; 1390-96.


Ghuran A, Reid F, La Rovere MT, Schmidt G, Bigger JT, Camm AJ, Schwartz PJ, Malik M.
Heart rate turbulence-based predictors of fatal and nonfatal cardiac arrest (The autonomic tone and reflexes after myocardial infarction substudy).
The American Journal of Cardiology; Vol. 89(2); January 15, 2002; 184-90.


Barthel P, Schneider R, Bauer A, Ulm K, Schmitt C, Schömig A, Schmidt G.
Risk stratification after acute myocardial infarction by heart rate turbulence.
Circulation. 2003 Sep 9;108(10):1221-6.


Jokinen V, Tapanainen JM, Seppänen T, Huikuri HV.
Temporal changes and prognostic significance of measures of heart rate dynamics after acute myocardial infarction in the beta-blocking era.
The American Journal of Cardiology, Volume 92, Issue 8, 15 October 2003, Pages 907-912.


Wojciech Z, Moss AJ.
Noninvasive Risk Stratification in Postinfarction Patients With Severe Left Ventricular Dysfuntion and Methodology of the MADIT II Noninvasive Electrocardiology Substudy.
Journal of Electrocardiology, Vol 38, Suppl. 2003, 101-8.


Wichterle D, Simek J, La Rovere MT, Schwartz PJ, Camm AJ, Malik M.
Prevalent Low-Frequency Oscillation of Heart Rate. Novel Predictor of Mortality After Myocardial Infarction.
Circulation.2004; 110: 1183-1190.


Malik M, Hnatkova K, Batchvarov VN.
Post Infarction Risk Stratification Using the 3-D Angle Between QRS Complex and T-Wave Vectors.
Journal of Electrocardiology, Vol. 37 Suppl. 2004, 201-8.


Mäkikallio TH, Barthel P, Schneider R, Bauer A, Tapanainen JM, Tulppo MP, Schmidt G, Huikuri HV.
Prediction of sudden cardiac death after acute myocardial infarction: role of Holter monitoring in the modern treatment era.
Eur. Heart J., April 2005; 26: 762 - 769.


Hallstrom AP, Stein PK, Schneider R, Hodges M, Schmidt G, Ulm K.
Characteristics of heart beat intervals and prediction of death.
International Journal of Cardiology Volume 100, Issue 1, 8 April 2005, Pages 37-45.


Bauer A, Guzik P, Barthel P, Schneider R, Ulm K, Watanabe MA, Schmidt G.
Reduced prognostic power of ventricular late potentials in post-infarction patients of the reperfusion era.
Eur Heart J 2005 26: 755-761


Zhang DQ, Huang JY, Fang YM, Wu YQ, Liang JR, Ma WY, Wang P, Qi LF, Liu XJ, Li CJ, Li HW, Jia SQ.
[Clinical research of heart rate turbulence on predictive value in patients with acute myocardial infarction.]
Zhonghua Xin Xue Guan Bing Za Zhi. 2005 Oct;33(10):903-6. (Article in Chinese)


Bauer A, Malik M, Barthel P, Schneider R, Watanabe MA, Camm AJ, Schömig A, Schmidt G.
Turbulence dynamics: An independent predictor of late mortality after acute myocardial infarction.
International Journal of Cardiology 107 (2006) 42-47.


Goernig M, Gramsch M, Baier V, Figulla HR, Leder U, Voss A.
Altered Autonomic Cardiac Control Predicts Restenosis After Percutaneous Coronary Intervention.
PACE 2006; Feb; Vol. 29, 188-91.


Carney RM, Howells WB, Blumenthal JA, Freedland KE, Stein PK, Berkman LF, Watkins LL, Czajkowski SM, Steinmeyer B, Hayano J, Domitrovich PP, Burg MM, Jaffe AS.
Heart Rate Turbulence, Depression, and Survival After Acute Myocardial Infarction.
Psychosom Med 2007 69: p. 4-9.


Perki¨om¨aki J, Jokinen V, Tapanainen J, Airaksinen J, Huikuri H
Autonomic Markers as Predictors of Nonfatal Acute Coronary Events after Myocardial Infarction.
ANE 2008; April; Vol. 13, No 2.


Exner DV, Kavanagh KM, Slawnych MP, Mitchell LB, Ramadan D, Aggarwal SG, Noullett C, Van Schaik A, Mitchell RT, Shibata MA, Gulamhussein S, McMeekin J, Tymchak W, Schnell G, Gillis AM, Sheldon RS, Fick GH, Duff HJ; REFINE Investigators.
Noninvasive risk assessment early after a myocardial infarction the REFINE study.
J Am Coll Cardiol. 2007 Dec 11;50(24):2275-84.


Hallstrom AP, Stein PK, Schneider R, Hodges M, Schmidt G, Ulm K; the CAST Investigators.
Characteristics of heart beat intervals and prediction of death.
Int J Cardiol. 2005 Apr 8;100(1):37-45.


Kurpesa M, Trzos E, Rechci?ski T, Krzemi?ska-Paku?a M.
The relationship between heart rate variability and heart rate turbulence dynamics after primary coronary angioplasty.
Ann Noninvasive Electrocardiol. 2007 Jan;12(1):50-8.


Risk Prediction - Acute infarction phase [Up]

Sade E, Aytemir K, Oto A, Nazli N, Ozmen F, Ozkutlu H, Tokgozoglu L, Aksoyek S, Ovunc K, Kabakci G, Ozer N, Kes S.
Assessment of heart rate turbulence in the acute phase of myocardial infarction for long-term prognosis.
Pacing Clin Electrophysiol. 2003 Feb;26(2 Pt 1):544-50.


Ortak J, Weitz G, Wiegand UK, Bode F, Eberhardt F, Katus HA, Richardt G, Schunkert H, Bonnemeier H.
Changes in heart rate, heart rate variability, and heart rate turbulence during evolving reperfused myocardial infarction.
Pacing Clin Electrophysiol. 2005 Jan;28 Suppl 1:S227-32.


Risk Prediction - Bypass surgery [Up]

Cygankiewicz I, Wranicz JK, Bolinska H, Zaslonka J, Jaszewski R, Zareba W.
Prognostic significance of heart rate turbulence in patients undergoing coronary artery bypass grafting.
Am J Cardiol 2003 Jun 15;91(12):1471-4.


Cygankiewicz I, Wranicz JK, Bolinska H, Zaslonka J, Jaszewski R, Zareba W.
Influence of coronary artery bypass grafting on heart rate turbulence parameters.
Am J Cardiol. 2004 Jul 15;94(2):186-9.


Risk Prediction - Congestive heart failure / dilative cardiomyopathy [Up]

Koyama J, Watanabe J, Yamada A, Koseki Y, Konno Y, Toda S, Shinozaki T, Miura M, Fukuchi M, Ninomiya M, Kagaya Y, Shirato K.
Evaluation of heart-rate turbulence as a new prognostic marker in patients with chronic heart failure.
Circ J 2002 Oct;66(10):902-7.


Berkowitsch A, Guettler N, Neumann T, Kurzidim K, Erdogan A, Pitschner HF.
Prognostic Significance of Heart-Rate Turbulence in ICD Patients with DCM.
The XIIth World Congress on Cardiac Pacing & Electrophysiology; Hong Kong, February 19-22, 2003; 299-303.


Grimm W, Sharkova J, Christ M, Müller HH, Schmidt G, Maisch B.
Prognostic Significance of Heart Rate Turbulence Following Ventricular Premature Beats in Patients with Idiopathic Dilated Cardiomyopathy.
J Cardiovasc Electrophysiol. 2003 Aug;14(8):819-824.


Moore RKG, Groves, DG, Barlow PE, Fox KAA, Shah A, Nolan J, Kearney MT.
Heart rate turbulence and death due to cardiac decompensation in patients with chronic heart failure.
Eur J Heart Fail. 2006 Oct;8(6):585-90. Epub 2006 Feb 10.


Calo L, de Ruvo E.
A turbulent era for congestive heart failure patients?
Heart Rhythm. 2008 Aug;5(8):1103-4. Epub 2008 May 29.


Cygankiewicz I, Zareba W, Vazquez R, Vallverdu M, Cino J, Cinca J, Almendral J, Gonzalez Juanatey JR, Macaya C, Valdes M, Caminal P, Bayes de Luna A.
Relation of heart rate turbulence to severity of heart failure.
Am J Cardiol. 2006 Dec 15;98(12):1635-40. Epub 2006 Oct 23.


Cygankiewicz I, Zareba W, Vazquez R, Vallverdu M, Gonzalez-Juanatey JR, Valdes M, Almendral J, Cinca J, Caminal P, de Luna AB; Muerte Subita en Insuficiencia Cardiaca Investigators.
Heart rate turbulence predicts all-cause mortality and sudden death in congestive heart failure patients.
Heart Rhythm. 2008 Aug;5(8):1095-102. Epub 2008 May 2.


Risk Prediction - Hypertrophic cardiomyopathy [Up]

Kawasaki T, Azuma A, Asada S, Hadase M, Kamitani T, Kawasaki S, Kuribayashi T, Sugihara H.
Heart rate turbulence and clinical prognosis in hypertrophic cardiomyopathy and myocardial infarction.
Circ J. 2003 Jul;67(7):601-4.


Kawasaki T, Azuma A, Taniguchi T, Asada S, Kamitani T, Kawasaki S, Matsubara H, Sugihara H.
Short-term fluctuations in sinus cycle length after premature ventricular beats in patients with hypertrophic cardiomyopathy and myocardial infarction.
International Journal of Cardiology; Vol. 101, Issue 2, 25 May 2005, 315-317.


Risk Prediction - Long QT syndrome [Up]

Onrat E, Kaya D, Celik A, Melek M, Kerpeten K, Kilit C, Barutcu I, Metin A.
Heart rate turbulence does not seem to be a good predictor in Long QT syndrome.
Arch Turk Soc Cardiol 2003;31:770-75.


Risk Prediction - Restenosis [Up]

Goernig M, Gramsch M, Baier V, Figulla HR, Leder U, Voss A.
Altered autonomic cardiac control predicts restenosis after percutaneous coronary intervention.
Pacing Clin Electrophysiol. 2006 Feb;29(2):188-91.


Risk Prediction - Ventricular Arrhytmia [Up]

Watanabe MA.
Heart rate turbulence slope reduction in imminent ventricular tachyarrhythmia and its implications.
J Cardiovasc Electrophysiol. 2006 Jul;17(7):735-40.


Iwasa A, Hwa M, Hassankhani A, Liu T, Narayan SM.
Abnormal heart rate turbulence predicts the initiation of ventricular arrhythmias.
Pacing Clin Electrophysiol. 2005 Nov;28(11):1189-97.


Risk Prediction - Elderly [Up]

Stein PK, Barzilay JI, Chaves PH, Mistretta SQ, Domitrovich PP, Gottdiener JS, Rich MW, Kleiger RE.
Novel Measures of Heart Rate Variability Predict Cardiovascular Mortality in Older Adults Independent of Traditional Cardiovascular Risk Factors: The Cardiovascular Health Study (CHS).
J Cardiovasc Electrophysiol. 2008 Jul 3.


Risk Prediction - Diabetes [Up]

Balcio?lu S, Arslan U, Türko?lu S, Ozdemir M, Cengel A.
Heart rate variability and heart rate turbulence in patients with type 2 diabetes mellitus with versus without cardiac autonomic neuropathy.
Am J Cardiol. 2007 Sep 1;100(5):890-3. Epub 2007 Jun 26.


HRT in miscellaneous diseases [Up]

Yilmaz F, Gunduz H, Karaaslan K, Arinc H, Cosgun M, Sessiz N, Uyan C.
Holter analyses in children with adenotonsillar hypertrophy.
Int J Pediatr Otorhinolaryngol. 2006 Apr 28; [Epub ahead of print].


Gunduz H, Arinc H, Kayardi M, Akdemir R, Ozyildirim S, Uyan C.
Heart rate turbulence and heart rate variability in patients with mitral valve prolapse.
Europace. 2006 Jul;8(7):515-20.


HRT in miscellaneous diseases - Chagas Disease [Up]

Ribeiro AL, Schmidt G, Sousa MR, Lombardi F, Gomes ME, Perez AA, Barros MV, Machado FS, Rocha MO.
Heart rate turbulence in chagas disease.
Pacing Clin Electrophysiol. 2003 Jan;26(1 Pt 2):406-10.


Tundo F, Lombardi F, Rocha MC, Botoni F, Schmidt G, Barros VC, Muzzi B, Gomes M, Pinto A, Ribeiro AL.
Heart rate turbulencenext term and left ventricular ejection fraction in Chagas disease.
Europace; Volume 7, Issue 3 , May 2005, Pages 197-203.


HRT in miscellaneous diseases - Hyperthyroidism [Up]

Osman F, Franklyn JA, Daykin J, Chowdhary S, Holderb RL, Sheppard MC, Gammage MD.
Heart rate variability and turbulence in hyperthyroidism before, during, and after treatment.
The American Journal of Cardiology, Vol. 94, 4, 15 August 2004, 465-9.


HRT in miscellaneous diseases - Sleep Apnea [Up]

Yang A, Schafer H, Manka R, Andrie R, Schwab JO, Lewalter T, Luderitz B, Tasci S.
Influence of obstructive sleep apnea on heart rate turbulence.
Basic Res Cardiol; Vol.100, No.5, September 2005; 439-445.


Aytemir K, Deniz A, Yavuz B, Ugur Demir A, Sahiner L, Ciftci O, Tokgozoglu L, Can I, Sahin A, Oto A.
Increased myocardial vulnerability and autonomic nervous system imbalance in obstructive sleep apnea syndrome.
Respir Med. 2007 Jun;101(6):1277-82. Epub 2006 Nov 29.


HRT in miscellaneous diseases - Left Ventricular Apical Ballooning [Up]

Ortak J, Kurowski V, Wiegand UKH, Bode F, Weitz G, Wilke I, Hartmann F, Schunkert H, Bonnemeier H.
Cardiac Autonomic Activity in Patients With Transient Left Ventricular Apical Ballooning.
JACC. Article in Press, Corrected Proof.


HRT in miscellaneous diseases - Depression [Up]

Carney RM, Howells WB, Blumenthal JA, Freedland KE, Stein PK, Berkman LF, Watkins LL, Czajkowski SM, Steinmeyer B, Hayano J, Domitrovich PP, Burg MM, Jaffe AS.
Heart rate turbulence, depression, and survival after acute myocardial infarction.
Psychosom Med. 2007 Jan;69(1):4-9. Epub 2006 Dec 13.


York KM, Hassan M, Sheps DS.
Psychobiology of depression/distress in congestive heart failure.
Heart Fail Rev. 2008 Mar 27.


HRT in miscellaneous diseases - Myotonic Dystrophy [Up]

Casella M, Dello Russo A, Pace M, Pelargonio G, Ierardi C, Sanna T, Messano L, Bencardino G, Valsecchi S, Mangiola F, Lanza GA, Zecchi P, Crea F, Bellocci F.
Heart rate turbulence as a noninvasive risk predictor of ventricular tachyarrhythmias in myotonic dystrophy type 1.
J Cardiovasc Electrophysiol. 2006 Aug;17(8):871-6.


HRT in miscellaneous diseases - Mitral Valve Prolapse [Up]

Chen HY.
Relationship of heart rate turbulence, heart rate variability and the number of ventricular premature beats in patients with mitral valve prolapse and non-significant regurgitation.
Int J Cardiol. 2008 Jul 4.


Gunduz H, Arinc H, Kayardi M, Akdemir R, Ozyildirim S, Uyan C.
Heart rate turbulence and heart rate variability in patients with mitral valve prolapse.
Europace. 2006 Jul;8(7):515-20.


HRT in miscellaneous diseases - Congenital Heart Disease [Up]

Davos CH, Moutafi AC, Alexandridi A, Petropoulou E, Varela E, Chamakou AC, Francis DP, Kilner PJ, Piepoli MF, Gatzoulis MA.
Heart rate turbulence in adults with repaired tetralogy of Fallot.
Int J Cardiol. 2008 Jul 4.


Role of HRT in prediction of atrial fibrillation [Up]

Vikman S, Lindgren K, Mäkikallio TH, Yli-Mäyry S, Airaksinen KEJ and Huikuri HV.
Heart rate turbulence after atrial premature beats before spontaneous onset of atrial fibrillation.
Journal of the American College of Cardiology, Volume 45, Issue 2, 18 January 2005, Pages 278-284.


Response to drugs - Betablockers [Up]

Lin LY, Hwang JJ, Lai LP, Chan HL, Du CC, Tseng YZ, Lin JL.
Restoration of Heart Rate Turbulence by Titrated Beta-Blocker Therapy in Patients with Advanced Congestive Heart Failure.
J Cardiovasc Electrophysiol. 2004 Jul;15(7):752-756.


Saxon LA.
Improvement in Heart Rate Turbulence as a Measure of Response to Beta-Blocker Therapy for Heart Failure.
J Cardiovasc Electrophysiol. 2004 Jul;15(7):757-758.


Bonnemeier H, Ortak J, Tolg R, Witt M, Schmidt J, Wiegand UK, Bode F, Schunkert H, Richardt G.
Carvedilol versus metoprolol in the acute phase of myocardial infarction: Differing Effects on Heart Rate Turbulence.
Pacing Clin Electrophysiol. 2005 Jan;28(1 Suppl):S222-6.


Response to drugs - Atropine [Up]

Marine JE, Watanabe MA, Smith TW, Monahan KM.
Effect of atropine on heart rate turbulence.
The American Journal of Cardiology; Vol. 89(6); March 15, 2002; 767-9.


Vukajlovic DD, Guettler N, Miric M, Pitschner HF.
Effects of Atropine and Pirenzepine on Heart Rate Turbulence.
A.N.E. 2006; 11(1):34-37.


Response to drugs - ACE inhibitors / AT1 blockers [Up]

Chowdhary S, Ozman F, Ng GA, Vaile J, Townend J.
Effects of Quinapril and Candesartan on 'Heart Rate Turbulence' in Heart Failure.
PACE 2000; Vol. 23; No. 4; Part II; 643.


Zhong JH, Chen XP, Zeng CF, Yun ML, Yang XW, Chen YF, Yao Z.
Effect of benazepril on heart rate turbulence in patients with dilated cardiomyopathy.
Clin Exp Pharmacol Physiol. 2007 Jul;34(7):612-6.


HRT in the healthy - Circadian behaviour [Up]

Cygankiewicz I, Wranicz JK, Bolinska H, Zaslonka J, Zareba W.
Circadian changes in heart rate turbulence parameters.
Journal of Electrocardiology, Volume 37, Issue 4, October 2004, Pages 297-303.


Watanabe MA, Alford M, Schneider R, Bauer A, Barthel P, Stein PK, Schmidt G.
Demonstration of circadian rhythm in heart rate turbulence using novel application of correlator functions.
Heart Rhythm. 2007 Mar;4(3):292-300. Epub 2006 Nov 18.


Nattel S, Comtois P.
Teasing out circadian variability in heart rate turbulence: A new approach to detecting biorhythms underlying cardiac function.
Heart Rhythm. 2007 Mar;4(3):301-3. Epub 2006 Dec 22.


HRT in the healthy - Normal HRT pattern [Up]

6 Nov 1.


Diaz JO, Castellanos A, Moleiro F, Interian A, Myerburg RJ.
Relation between sinus rates preceding and following ectopic beats occurring in isolation and as episodes of bigeminy in young healthy subjects.
Am J Cardiol 2002 Aug 1;90(3):332-5.


Grimm W, Sharkova J, Christ M, Schneider R, Schmidt G, Maisch B.
Heart Rate Turbulence following Ventricular Premature Beats in Healthy Controls.
Annals of Noninvasive Electrocardiology 2003 April; 8(2); 127-31.


Lindgren KS, Mäkikallio TH, Seppänen T, Raatikainen MJP, Castellanos A, Myerburg RJ, Huikuri HV.
Heart Rate Turbulence after Ventricular and Atrial Premature Beats in Subjects without Structural Heart Disease.
J Cardiovasc Electrophysiol, Vol. 14, pp. 447-452, May 2003.


Sestito A, Valsecchi S, Infusino F, Sgueglia GA, Bellocci F, Zecchi P, Crea F, Lanza GA.
Differences in heart rate turbulence between patients with coronary artery disease and patients with ventricular arrhythmias but structurally normal hearts.
The American Journal of Cardiology; Vol. 93; May 1, 2004; 1114-1118.


Schwab JO, Eichner G, Shlevkov N, Schrickel J, Yang A, Balta O, Lewalter T, Luderitz B.
Impact of age and basic heart rate on heart rate turbulence in healthy persons.
Pacing Clin Electrophysiol. 2005 Jan;28(1 Suppl):S198-201.


Schwab JO, Eichner G, Balta O, Luderitz B.
Determinants of Heart Rate Turbulence after Ventricular Premature Beats in Healthy Volunteers.
Hellenic J Cardiol 46: 31-34, 2005.


Davies LC, Francis DP, Ponikowski P, Piepoli MF, Coats AJS.
Relation of Heart Rate and Blood Pressure Turbulence Following Premature Ventricular Complexes to Baroreflex Sensitivity in Chronic Congestive Heart Failure.
The American Journal of Cardiology; Vol. 87; March 15, 2001; 737-42.


Voss A, Baier V, Schumann A, Hasart A, Reinsperger F, Schirdewan A, Osterziel KJ, Leder U.
Postextrasystolic regulation patterns of blood pressure and heart rate in patients with idopathic dilated cardiomyopathy.
J Physiol; Vol. 538(Pt 1); January 1, 2002; 271-8.


Voss A, Baier V, Hopfe J, Schirdewan A, Leder U.
Heart rate and blood pressure turbulence-marker of the baroreflex sensitivity or consequence of postextrasystolic potentiation and pulsus alternans?
The American Journal of Cardiology; Vol. 89(1); January 1, 2002; 110-1.


Lin LY, Lai LP, Lin JL, Du CC, Shau WY, Chan HL, Tseng YZ, Huang SK.
Thight mechanism correlation between heart rate turbulence and baroreflex sensitivity: sequential autonomic blockade analysis.
J Cardiovasc Electrophysiol. 2002 May; 13(5); 427-31.


Roach D, Koshman ML, Duff H, Sheldon R.
Induction of heart rate and blood pressure turbulence in the electrophysiologic laboratory.
Am J Cardiol 2002 Nov 15;90(10):1098-102.


Roach D, Koshman ML, Duff H, Sheldon R.
Similarity of spontaneous and induced heart rate and blood pressure turbulence.
Can J Cardiol. 2003 Nov;19(12):1375-1379.


Davies JI, Witham MD, Struthers AD.
Autonomic Effects of Spironolactone and MR Blockers in Heart Failure.
Heart Fail Rev. 2005 Jan;10(1):63-9.


Iwasaki M, Yuasa F, Yuyama R, Mimura J, Kawamura A, Motohiro M, Yo M, Sugiura T, Iwasaka T.
Correlation of Heart Rate Turbulence with Sympathovagal Balance in Patients with Acute Myocardial Infarction.
Clinical and Experimental Hypertension; Volume 27, Number 2-3 / 2005.


Raj SR, Sheldon RS, Koshman M, Roach DE.
Role of hypotension in heart rate turbulence physiology.
Heart Rhythm, 2(8), August 2005, 820-7.


Wichterle D, Melenovsky V, Simek J, Malik J, Malik M.
Hemodynamics and Autonomic Control of Heart Rate Turbulence.
Journal of Cardiovascular Electrophysiology, Vol. 17, No. 3, March 2006, 286-291.


Sato N, Yamamoto T, Akutsu K, Fujita N, Asai K, Takayama M, Takano T, Tanaka K.
Arterial baroreflex sensitivity is a good predictor of inotropic responses to a phosphodiesterase inhibitor in human heart failure.
Clin Cardiol. 2006 Jun;29(6):263-7.


Makai A, Korsós A, Makra P, Forster T, Abrahám G, Rudas L.
Spontaneous baroreflex sensitivity and heart rate turbulence parameters: parallel responses to orthostasis.
Clin Auton Res. 2008 Apr;18(2):74-9.


Mechanism of HRT - Ischemia [Up]

Bonnemeier H, Wiegand UKH, Friedlbinder J, Schulenburg S, Hartmann F, Bode F, Katus HA, Richardt G.
Reflex Cardiac Activity in Ischemia and Reperfusion. Heart Rate Turbulence in Patients Undergoing Direct Percutaneous Coronary Intervention for Acute Myocardial Infarction.
Circulation. 2003;108:958-964.


Ortak J, Weitz G, Wiegand UK, Bode F, Eberhardt F, Katus HA, Richardt G, Schunkert H, Bonnemeier H.
Changes in Heart Rate, Heart Rate Variability, and Heart Rate Turbulence during Evolving Reperfused Myocardial Infarction.
Pacing Clin Electrophysiol. 2005 Jan;28(1 Suppl):S227-32.


Tuomainen P, Hartikainen J, Vanninen E, Peuhkurinen K.
Warm-up phenomenon and cardiac autonomic control in patients with coronary artery disease.
Life Sciences, Volume 76, Issue 19, 25 March 2005, Pages 2147-2158.


Mechanism of HRT - Ectopy characteristics [Up]

Watanabe MA, Marine JE, Sheldon R, Josephson ME.
Effects of Ventricular Premature Stimulus Coupling Interval on Blood Pressure and Heart Rate Turbulence.
Circulation. 2002; 106:325-330.


Savelieva I, Wichterle D, Harries M, Meara M, Camm AJ, Malik M.
Heart rate turbulence after atrial and ventricular premature beats: relation to left ventricular function and coupling intervals.
Pacing Clin Electrophysiol. 2003 Jan;26(1 Pt 2):401-5.


Schwab JO, Shlevkov N, Grunwald K, Schrickel JW, Yang A, Lickfett L, Lewalter T, Luderitz B.
Influence of the point of origin on heart rate turbulence after stimulated ventricular and atrial premature beats.
Basic Res Cardiol. 2004 Jan;99(1):56-60. Epub 2003 Nov 14.


Lee KT, Lai WT, Chu CS, Yen HW, Voon WC, Sheu SH.
Effect of electrophysiologic character of ventricular premature beat on heart rate turbulence.
Journal of Electrocardiology. 2004 Jan;37(1):41-46.


Wichterle D, Bulkova V, Fikar M, Havranek S, Stovicek P.
Heart Rate Turbulence after Atrial Premature Complexes Depends on Coupling Interval and Atrioventricular Nodal Conduction.
PACE 2007; 30:S174-7.


Flevari P, Georgiadou P, Leftheriotis D, Livanis E, Theodorakis G, Th Kremastinos D.
Heart rate turbulence after short runs of nonsustained ventricular tachycardia in chronic heart failure.
Pacing Clin Electrophysiol. 2007 Jun;30(6):787-95.



Jeron A, Kaiser T, Hengstenberg C, Lowel H, Riegger GA, Holmer S.
Association of the Heart Rate Turbulence with Classic Risk Stratification Parameters in Postmyocardial Infarction Patients.
Annals of Noninvasive Electrocardiology 2003 Oct; 8(4); 296-301.


Cygankiewicz I, Wranicz JK, Bolinska H, Zaslonka J, Zareba W.
Relationship Between Heart Rate Turbulence and Heart Rate, Heart Rate Variability, and Number of Ventricular Premature Beats in Coronary Patients.
J Cardiovasc Electrophysiol. 2004 Jul;15(7):731-737.


Schwab JO, Eichner G, Veit G, Schmitt H, Lewalter T, Luderitz B.
Influence of basic heart rate and sex on heart rate turbulence in healthy subjects.
Pacing Clin Electrophysiol. 2004 Dec;27(12):1625-31.


Havranek S, Stovicek P, Psenicka M, Wichterle D, Linhart A.
Heart rate turbulence after ventricular pacing trains during programmed ventricular stimulation.
Pacing Clin Electrophysiol. 2007 Jan;30 Suppl 1:S170-3.


Schwab JO, Eichner G, Shlevkov N, Schrickel J, Yang A, Balta O, Lewalter T, Lüderitz B.
Impact of age and basic heart rate on heart rate turbulence in healthy persons.
Pacing Clin Electrophysiol. 2005 Jan;28 Suppl 1:S198-201.


Mechanism of HRT - Mathematical models [Up]

Mrowka R, Persson PB, Theres H, Patzak A.
Blunted arterial baroreflex causes "pathological" heart rate turbulence.
Am J Physiol Regulatory Integrative Comp Physiol 2000; Vol. 279; R1171-5.


Baumann M, Meesmann M.
Modeling the Blood Pressure Response to a Ventricular Premature Complex with Special Reference to Heart Rate Turbulence.
Cardiovascular Engineering: An International Journal, June 2004, vol. 4, no. 2, pp. 139-147(9).


Mechanism of HRT - Other [Up]

Ouvrard-Pascaud A, Sainte-Marie Y, Benitah JP, Perrier R, Soukaseum C, Nguyen Dinh Cat A, Royer A, Quang KL, Charpentier F, Demolombe S, Mechta-Grigoriou F, Beggah AT, Maison-Blanche P, Oblin ME, Delcayre C, Fishman GI, Farman N, Escoubet B, Jaisser F.
Conditional Mineralocorticoid Receptor Expression in the Heart Leads to Life-Threatening Arrhythmias.
Circulation. 2005;111:3025-3033.


Technical aspects - Standard algorithm [Up]

Schneider R, Barthel P, Bauer A, Schmidt G.
Heart Rate Turbulence Website.


Schneider R, Barthel P, Watanabe M.
Heart Rate Turbulence on Holter.
in 'Dynamic Electrocardiography', edited by Marek Malik and A. John Camm; Blackwell Futura Publishing; 2004.


Technical aspects - Alternative algorithms [Up]

Berkowitsch A, Zareba W, Neumann T, Erdogan A, Mc Nitt S, Moss AJ, Pitschner HF.
Risk Stratification Using Heart Rate Turbulence and Ventricular Arrhythmia in MADIT II: Usefulness and Limitations of a 10-Minute Holter Recording.
Ann of Noninvasive Electrocardiology 2004; 9: 270-279.


Hallstrom AP, Stein PK, Schneider R, Hodges M, Schmidt G, Ulm K.
Structural Relationships Between Measures Based on Heart Beat Intervals: Potential for Improved Risk Assessment.
IEEE Transactions on Biomedical Engineering, Vol. 51, No. 8, August 2004, 1414-20.


Malberg H, Bauernschmitt R, Meyerfeldt U, Schirdewan A, Wessel N.
Short-term Heart Rate Turbulence Analysis Versus Variability and Baroreceptor Sensitivity in Patients With Dilated Cardiomyopathy.
Indian Pacing and Electrophysiology Journal. 2004;4:162-175.


Wichterle D, Camm AJ, Malik M.
Turbulence slope after atrial premature complexes is an independent predictor of mortality in survivors of acute myocardial infarction.
J Cardiovasc Electrophysiol. 2004 Dec;15(12):1350-6.


Bauer A, Malik M, Barthel P, Schneider R, Watanabe MA, Camm AJ, Schömig A, Schmidt G.
Turbulence dynamics: an independent predictor of late mortality after acute myocardial infarction.
Int J Cardiol. 2006 Feb 8;107(1):42-7.


Other VPC-triggered turbulences - AV conduction [Up]

Wichterle D, Savelieva I, Meara M, Camm AJ, Malik M.
Paradoxical autonomic modulation of atrioventricular nodal conduction during heart rate turbulence.
Pacing Clin Electrophysiol. 2003 Jan;26(1 Pt 2):440-3.


Other VPC-triggered turbulences - QT interval [Up]

Savelieva I, Wichterle D, Camm JA.
QT-Interval Turbulence Induced by Atrial and Ventricular Extrastimuli in Patients with Ventricular Tachycardia.
Pacing Clin Electrophysiol. 2005 Jan;28(1 Suppl):S187-92.


Letters [Up]

Avolio A, O'Rourke M, Watanabe MA, Marine JE, Sheldon R, Josephson ME.
Letter to 'Effects of Ventricular Premature Stimulus Coupling Interval on Blood Pressure and Heart Rate Turbulence.' and Response.
Circulation. 2003 Feb 11;107(5):E38-8; author reply E38-8.


Wessel N, Malberg H.
Heart Rate Turbulence: An Independent Risk Factor? (Letter to: 'Heart Rate Turbulence after Ventricular and Atrial Premature Beats in Subjects without Structural Heart Disease.' by Lindgren et al.).
J Cardiovasc Electrophysiol. 2003 Dec;14(12):1388.


Wessel N, Malberg H, Walther T, Barthel P, Schneider R, Bauer A, Ulm K, Schmitt C, Schömig A, Schmidt G.
Heart Rate Turbulence: Higher Predictive Value Than Other Risk Stratifiers? and Response.
Circulation. 2004;109:e150-e151.


Wichterle D, Malik M.
Physiological Mechanisms of Atrially Induced Heart Rate Turbulence (Letter to: 'Heart rate turbulence after atrial premature beats before spontaneous onset of atrial fibrillation' by Vikman et al.).
JACC Vol. 46, No. 6, 2005, 1113-4.


Infarction' and Response.
Circulation, Apr 2005; 111: e180 - e181.


Editorials [Up]

Peter W Macfarlane.
Renaissance in electrocardiography.
Lancet 1999; Vol. 353; No. 9162; 1377-9.


Stein PK.
Heart Rate Turbulence: Explorations of an Emerging Risk Factor.
J Cardiovasc Electrophysiol, Vol. 14, pp. 453-454, May 2003.


Tulppo M, Huikuri HV.
Editorial Comment: Origin and Significance of Heart Rate Variability.
JACC, Vol. 43, No. 12, 2004, 2278-80.


Watanabe MA.
Editorial: Role of hypotension in heart rate turbulence.
Heart Rhythm, 2(8), August 2005, 828-9.


Bauer A, Schmidt G.
Editorial: Last piece of the heart rate turbulence puzzle?
Heart Rhythm 2007; Vol 4(3); 290-1.


Nattel S, Comtois P.
Teasing out circadian variability in heart rate turbulence: A new approach to detecting biorhythms underlying cardiac function.
Heart Rhythm 2007; Vol 4(3); 301-3.


Calo L, de Ruvo E.
A turbulent era for congestive heart failure patients?
Heart Rhythm. 2008 Aug;5(8):1103-4. Epub 2008 May 29.


Review Articles [Up]

Schmdit G, Schneider R, Barthel P.
Heart Rate Turbulence.
Cardiac Electrophysiology Review 1999; 3; 297-301.


Malik M, Wichterle D, Schmidt G.
Heart-rate turbulence.
G Ital Cardiol 1999; Vol. 29; Suppl 5; 65-9.


Guzik P, Schmidt G.
A Phenomenon of Heart-Rate Turbulence, Its Evaluation, and Prognostic Value.
Card Electrophysol Rev. 2002 Sep; 6(3) 256-61.


Wichterle D, Melenovsky V, Malik M.
Mechanisms involved in Heart Rate Turbulence.
Card Electrophysol Rev. 2002 Sep; 6(3) 262-6.


Cygankiewicz I, Wranicz JK, Bolinska H, Zaslonka J, Zareba W.
Heart Rate Turbulence in Patients With Coronary Artery Disease.
International Journal of Bioelectromagnetism, Vol. 4, No. 2, 2002, 287-8.


Watanabe MA.
Heart Rate Turbulence: a Review.
Indian Pacing and Electrophysiology Journal. 2003;3:10-22.


De Ambroggi L.
Clinical Use of Holter ECG Recordings.
International Journal of Bioelectromagnetism. Vol. 5, No. 1, 2003. pp. 164 - 166.


Bauer A, Schmidt G.
Heart Rate Turbulence.
Journal of Electrocardiology. Vol. 36, Supplement 2003, pages 89-93.


Barthel P, Bauer A, Schneider R, Schmidt G.
Risk Stratification by Heart Rate Turbulence in Post-Infarction Patients.
Ital Heart J 2004; 5 (suppl 1): 162S-165S.


Verrier RL, Antzelevitch C.
Autonomic aspects of arrhythmogenesis: the enduring and the new.
Curr Opin Cardiol. 2004 Jan;19(1):2-11.


Watanabe MA, Schmidt G.
Heart rate turbulence: A 5-year review.
Heart Rhythm 2004;1:732-738.


Francis J, Watanabe MA, Schmidt G.
Heart rate turbulence: a new predictor for risk of sudden cardiac death.
Ann Noninvasive Electrocardiol. 2005 Jan;10(1):102-9.


Wichterle D, Simek J, Camm J, Malik M.
Predictive characteristics of Holter-based postinfarction risk stratifiers appear superior to electrophysiological testing.
Pacing Clin Electrophysiol. 2005 Jan;28(1 Suppl):S182-6.


Winslow RD, Mehta D, Fuster V.
Sudden cardiac death: mechanisms, therapies and challenges.
Nature Clinical Practice Cardiovascular Medicine, July 2005, Vol. 2(7), 352-60.


Cygankiewicz I, Zareba W.
Heart Rate Turbulence - New Risk Stratification Tool in Cardiology.
Türk Aritmi, Pacemaker ve Elektrofizyoloji Dergisi; Cilt 3, Sayi 1, Subat 2005, 17-26.


Enseleit F, Duru F.
Long-term continuous external electrocardiographic recording: a review.
Europace 2006 8(4):255-266.


Arya A, Haghjoo M, Sadr-Ameli MA.
Risk stratification for arrhythmic death after myocardial infarction: Current perspective and future direction.
International Journal of Cardiology; Vol. 108, Issue 2 , 4 April 2006, Pages 155-164.


Cygankiewicz I, Zareba, W.
Heart rate turbulence - an overview of methods and applications.
Folia Cardiol., 2006, Vol. 13, No. 5, pp. 359-368.


Josephson ME, Rosen MR, Tomaselli GF.
The year in arrhythmias--2007: Part I.
Heart Rhythm. 2008 May;5(5):742-8. Epub 2008 Mar 14.


Davies JI, Witham MD, Struthers AD.
Autonomic effects of spironolactone and MR blockers in heart failure.
Heart Fail Rev. 2005 Jan;10(1):63-9.


York KM, Hassan M, Sheps DS.
Psychobiology of depression/distress in congestive heart failure.
Heart Fail Rev. 2008 Mar 27.