Zmienność rytmu serca w ujęciu praktycznym — doceniany czy zapomniany parametr oceny holterowskiej?

Heart rate variability estimates oscillations in intervals between heart beats represented by variable RR intervals on ECG record. Reduced heart rate variability is considered a non-invasive marker of autonomic dysfunction, which can predict a wide range of cardiovascular diseases leading to sudden cardiac death.Zmienność rytmu serca (HRV) jest parametrem do oceny oscylacji w przerwach między uderzeniami serca odzwierciedlonej w odstępach RR zapisu elektrokardiograficznego. Obniżoną HRV uważa się za nieinwazyjny marker dysfunkcji układu autonomicznego, który może być czynnikiem predykcyjnym wielu chorób układu sercowo-naczyniowego prowadzących do zwiększonego ryzyka nagłego zgonu sercowego

All-cause readmission and repeat revascularization after percutaneous coronary intervention

Background: Percutaneous coronary intervention (PCI) is one of the most frequently performed cardiac interventions. However, there is limited data regarding the cause of recurrent hospitalization and repeat revascularization. The aim of this study was to assess re-hospitalization and repeat revascularization within 30 days of the initial hospitalization for PCI, using data from Opolskie Voivodeship, National Health Fund (NHF) Registry. Methods: The study population consisted of all PCI patients treated in three interventional cardiology laboratories in Opolskie Voivodeship in Poland between 1 July 2008 and 30 June 2009. All PCI patients who died during the initial hospitalization or who were transferred to other units were excluded from the analysis. The study end-point comprised 30 day all-cause readmission and repeat revascularization. Results: A total of 2,039 PCI patients were included in the analysis. The all-cause 30-day readmission rate was 14.6%. The 30-day readmission rate of acute coronary syndrome (ACS) patients was significantly higher compared to the stable coronary disease patients (ACS 15.8%, non-ACS 10.7%, p = 0.008). The 30-day readmission rate did not differ between the three cardiac laboratories. Approximately half (46.2%) of all readmitted patients underwent a repeat revascularization procedure, mainly in the form of PCI. The overall all-cause 30-day mortality rate was 0.8%. Compared to the PCI patients who did not require readmission, the readmitted patients had a significantly higher all-cause 30-day mortality rate (3.6% vs 0.3%, p < 0.001). Conclusions: Almost one in seven PCI patients requires readmission within 30 days of hospital discharge. Approximately 50% of all readmitted PCI patients resulted in a repeat revascularization procedure. PCI patients who were readmitted within 30 days of an index PCI procedure had a significantly higher all-cause 30-day mortality rate. (Cardiol J 2012; 19, 2: 174&#8211;179