Spectral analysis of heart period variance (HPV)--a tool to stratify risk following myocardial infarction

The purpose of this study was to contribute to the improvement of stratification of post-myocardial infarction patients at increased risk of malignant ventricular arrhythmia (MVA). Power spectral analysis of heart period variability (HPV) was used as a non-invasive tool to assess cardiac autonomic control. Three groups were used: (1) post-myocardial infarction patients with MVA; (2) post-myocardial infarction patients without MVA; and (3) a control group without heart disease. Spectral analysis of HPV (AR model) was performed on four minute long RR-interval time series derived from consecutive hours of Holter ECG. Significant decrease of powers of mid-frequency (MF) (70-150 mHz) and high-frequency (HF) (150-450 mHz) spectral components of HPV was obtained in Group 1 as compared to Group 2 (p = 0.001 and p = 0.02, respectively). There were no significant differences between groups concerning the power of low frequency (LF) (10-70 mHz) component HPV, spectra of patients in Group 1 were dominated by a single low frequency spectral peak (with a central frequency of 37 mHz). The relative power was computed as the percentage of power in each of the above (HF, MF, LF) components related to the total spectral power. Highly significant differences (p = 0.04) were obtained between Group 1 and Group 2 concerning relative powers of MF and LF components as well as LF/MF ratio. The above method appeared to be highly sensitive in differentiating patients with increased risk of MVA.