Eur Heart J-1996-Malik-354-81

Eur Heart J-1996-Malik-354-81 - European Heart Journal...

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Unformatted text preview: European Heart Journal (1996) 17, 354-381 Guidelines Heart rate variability Standards of measurement, physiological interpretation, and clinical use Task Force of The European Society of Cardiology and The North American Society of Pacing and Electrophysiology (Membership of the Task Force listed in the Appendix) Introduction The last two decades have witnessed the recognition of a significant relationship between the autonomic nervous system and cardiovascular mortality, including sudden cardiac death' 1 ^* 1 . Experimental evidence for an associ- ation between a propensity for lethal arrhythmias and signs of either increased sympathetic or reduced vagal activity has encouraged the development of quantitative markers of autonomic activity. Heart rate variability (HRV) represents one of the most promising such markers. The apparently easy derivation of this measure has popularized its use. As many commercial devices now provide automated measurement of HRV, the cardiologist has been pro- vided with a seemingly simple tool for both research and clinical studies' 51 . However, the significance and meaning of the many different measures of HRV are more complex than generally appreciated and there is a potential for incorrect conclusions and for excessive or unfounded extrapolations. Recognition of these problems led the European Society of Cardiology and the North American Society Key Words: Heart rate, electrocardiograph^, computers, autonomic nervous system, risk factors. The Task Force was established by the Board of the European Society of Cardiology and co-sponsored by the North American Society of Pacing and Electrophysiology. It was organised jointly by the Working Groups on Arrhythmias and on Computers of Cardiology of the European Society of Cardiology. After ex- changes of written views on the subject, the main meeting of a writing core of the Task Force took place on May 8-10, 1994, on Necker Island. Following external reviews, the text of this report was approved by the Board of the European Society of Cardiology on August 19, 1995, and by the Board of the North American Society of Pacing and Electrophysiology on October 3, 1995. Published simultaneously in Circulation. Correspondence Marek Malik, PhD, MD, Chairman, Writing Committee of the Task Force, Department of Cardiological Sciences, St. George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK. of Pacing and Electrophysiology to constitute a Task Force charged with the responsibility of developing appropriate standards. The specific goals of this Task Force were to: standardize nomenclature and develop definitions of terms; specify standard methods of measurement; define physiological and pathophysio- logical correlates; describe currently appropriate clinical applications, and identify areas for future research....
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Eur Heart J-1996-Malik-354-81 - European Heart Journal...

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