Heart rate turbulence as a marker of myocardial electrical instability in children with hypertrophic cardiomyopathy
Abstract
Heart rate turbulence is a myocardial electrical instability marker used to stratify the risk of sudden cardiac death. Fifty children aged 7 to 17 years with hypertrophic cardiomyopathy were examined. The survey program included standard electrocardiography, Doppler echocardiography, and 24-hour Holter ECG monitoring. Heart rate turbulence parameters, such as turbulence onset and turbulence slope, were analyzed. According to turbulence onset greater than zero, heart rate turbulence impairment was identified in 5 of the 24 patients included in the survey. The abnormal turbulence slope values of less than 6 msec/RR were found in 3 patients. Both parameters were abnormal in 1 patient. Heart rate turbulence impairment was significantly more common in children with the non-obstructive form of hypertrophic cardiomyopathy than in those with its obstructive form (χ2=3,05; p=0,08). All the children with abnormal heart rhythm turbulence values had one or more major risk factors for sudden cardiac death, which significantly exceeds their rates in the normal heart rate turbulence groups (χ2=7,11; p=0,007). The patients with abnormal turbulence onset values were more often found to have syncope (χ2=3,2; p=0,02). One such patient was recorded to have unstable ventricular tachycardia (χ2=10,56; p=0,001). Our findings suggest that heart rate turbulence is an additional predictor of the unfavorable course of hypertrophic cardiomyopathy in children.
About the Authors
V. A. Makarova
Research Clinical Institute of Pediatrics, Moscow
Russian Federation
Russian Federation
I. V. Leontieva
Research Clinical Institute of Pediatrics, Moscow
Russian Federation
Russian Federation
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Review
For citations:
Makarova V.A., Leontieva I.V. Heart rate turbulence as a marker of myocardial electrical instability in children with hypertrophic cardiomyopathy. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2014;59(4):64-68. (In Russ.)
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