RT-212
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Impact on clinical management of
autonomic markers for risk stratification
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Maria Teresa La Rovere.
Divisione di Cardiologia, Fondazione "S. Maugeri", IRCCS, Centro Medico
Montescano, Pavia, Italy
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Abstract
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In patients surviving myocardial infarction non
invasive risk assessment for arrhythmic events based on left ventricular function,
ambulatory arrhythmias, and signal averaged ECGs has not yet provided an effective
identification of the individual patient at risk. Over the last two decades it has been
convincingly demonstrated that the autonomic nervous system plays a critical role in the
genesis of life-threatening arrhythmias particularly in the presence of ischemic heart
disease. Assessment of heart rate variability (HRV) and analysis of baroreflex sensitivity
(BRS) represent two clinically applicable methods for determination of
sympathetic-parasympathetic interactions at the level of the sinus node. This article
reviews the clinical application of autonomic markers in patients after myocardial
infarction and their clinical usefulness in improving non invasive risk stratification.
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Key Words
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Autonomic nervous system evaluation
lethal arrhythmias, postmyocardial patients, left ventricular function, heart rate
variability, baroreflex sensitivity, reflex chronotropic response to a blodd pressure
change, autonomic markers, risk stratification, EMIAT trial, MADIT trial, ATRAMI trial, R
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