Increased Heart Rate Fragmentation Predicts Mortality Risk among End-Stage Renal Disease

Emi Yuda, Masaya Kisohara, Junichiro Hayano, Yoshifumi Moriyama, Norihiro Ueda

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Heart rate fragmentation (HRF) is a type of sinoatrial instability characterized by frequent (often every beat) appearance of peak and valley in R-R interval time series despite that ECG shows sinus rhythm. Differing from conventional heart rate variability (HRV) mediated by fluctuations in cardiac autonomic activity, HRF is thought to generate within the sinoatrial node of the heart. In this study, we examined the prognostic value of HRF in clinical ECG data. We assessed HRF in 24-hr Holter ECGs that were recorded between January and February in 2010 in 198 chronic hemodialysis patients with end-stage renal disease (ESRD). All ECG recordings showed continuous sinus rhythm and HRF was assessed as the percentage of inflection points (PIP) in 24-h R-R interval time series. We assessed the prognostic value of PIP by the proportional hazard regression analysis of all-cause mortality risk. Among 198 patients, 82 (41%) were diabetes. During followed up for 9 years, 81 (41%) died. Univariate regression analysis showed that age, decrease in very-low-frequency HRV components, and increase in PIP were significant predictors of mortality risk (risk ratio, 1.034 [95% CI, 1.012-1.057], P = 0.002). The predictive power of PIP was independent of age (1.026 [1.003-1.050], P = 0.02). PIP is a new ECG maker of mortality risk among ESRD patients on chronic hemodialysis treatment.

Original languageEnglish
Title of host publication2020 14th International Symposium on Medical Information Communication Technology, ISMICT 2020
PublisherIEEE Computer Society
ISBN (Electronic)9781728166179
DOIs
Publication statusPublished - 2020 May
Event14th International Symposium on Medical Information Communication Technology, ISMICT 2020 - Nara, Japan
Duration: 2020 May 202020 May 22

Publication series

NameInternational Symposium on Medical Information and Communication Technology, ISMICT
Volume2020-May
ISSN (Print)2326-828X
ISSN (Electronic)2326-8301

Conference

Conference14th International Symposium on Medical Information Communication Technology, ISMICT 2020
CountryJapan
CityNara
Period20/5/2020/5/22

Keywords

  • end-stage renal disease
  • heart rate fragmentation
  • hemodialysis
  • Holter ECG
  • mortality

ASJC Scopus subject areas

  • Computer Networks and Communications
  • Information Systems
  • Health Informatics
  • Health Information Management

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