Summary
Children may die suddenly and unexpectedly following cardiac surgery, even while receiving intensive medical care, when current noninvasive and invasive monitoring techniques fail to warn us of an impending problem. This report examines the efficacy of heart-rate spectral analysis, a noninvasive method that quantitates the beat-to-beat fluctuations in heart rate, in characterizing and tracking cardiovascular regulatory status. A total of 45 heart-rate fluctuation studies, performed on selected patients, at the bedside, using heart-rate spectral analysis, were retrospectively correlated with clinical events. The spectral pattern of 18 patients who sustained a cardiac arrest differed significantly from the others in the study group (p<0.0001).
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Akselrod S, Gordon D, Ubel FA, Shannon DC, Cohen RJ (1981) Power spectral analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control.Science 213:220–223
Akselrod S, Arbel J, Oz O, Benary V, David D (1985)Spectral analysis of hr fluctuations in the evaluation of autonomic control during acute myocardial infarction. IEEE Comput Soc Comput Cardiol, pp 315–318
Akselrod S, Gordon D, Madwed J, Shannon DC, Cohen RF (1985) Hemodynamic regulation: investigation by spectral analysis.Am J Physiol 249 [Heart Circ Physiol 18]:H867-H875
Berger RD, Akselrod S, Gordon D, Cohen RJ (1986) An efficient algorithm for spectral analysis of heart rate variability.IEEE Trans Biomed Eng 33:900–904
Chidsey CA, Braunwald E (1966) Sympathetic activity and neurotransmitter depletion in congestive heart failure.Pharmacol Rev 18:685–700
Cooley JW, Tukey JW (1965) An algorithm for the machine calculation of complex Fourier series.Math Comput 19:297–301
Gordon D, Southall D, Kelly D, Wilson A, Akselrod S, Richards J, Kenet B, Kenet R, Cohen RJ, Shannon DC (1986) Analysis of heart rate and respiratory patterns in sudden infant death syndrome (SIDS) victims and control infants.Pediatr Res 20:680–684
Hyndman BW (1980) Cardiovascular recovery to psychological stress: a means to diagnose man and task? In: Kitney RI, Rompelman O (eds)The study of heart-rate variability. Oxford University Press, Oxford, pp 191–224
Kitney RI (1980) An analysis of the thermoregulatory influences on heart-rate variability. In: Kitney RI, Rompelman O (eds)The study of heart-rate variability. Oxford University Press, Oxford, pp 81–106
Kitney RI, Byrne S, Edmonds ME, Watkins PJ, Roberts VC (1982) Heart rate variability in the assessment of autonomic diabetic neuropathy.Automedica 4:155–167
Levy MN, Vassalle M (eds) (1982)Excitation and neural control of the heart. Waverly Press, Baltimore
Madwed JB, Sands KEF, Saul JP, Cohen RJ (1986) Spectral analysis of beat-to-beat variability in heart rate and arterial blood pressure during hemorrhage and aortic constriction. In: Lown B, Malliani A, Prosdocimi M (eds)Neural mechanisms and cardiovascular disease [Fidia Research Series 5:291–302]. Springer-Verlag, Berlin
Oppenheim AV, Schafer RW (1975)Digital signal processing. Prentice-Hall, Englewood Cliffs NJ
Pagani M, Lombardi F, Guzzetti S, Rimoldi O, Furlan R, Pizzinelli P, Sandrone G, Mulfatto G, Dell'Orto S, Piccaluga E, Turiel M, Baselli G, Cerutti S, Malliani A (1986) Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog.Circ Res 59:178–193
Pomeranz B, Macaulay RJB, Caudill MA, Kutz I, Adam D, Gordon D, Barger AC, Shannon DC, Cohen RJ, Benson H (1985) Assessment of autonomic function in humans by heart rate spectral analysis.Am J Physiol 248:H151-H153
Raeder EA, Berger R, Kenet R, Kiely JP, Lehnert H, Cohen RJ, Lown B (1987) Assessment of autonomic cardiac control by power spectrum of heart rate fluctuations in anesthetized dogs.J Appl Cardiol (in press)
SAS Institute Inc. (1985)User's guide: statistics, version 5 edn. SAS Institute, Cary NC, pp 113–118 and 607–614
SAS Institute Inc. (1985)User's guide: statistics, version 5 edn. SAS Institute, Cary NC, p 126
Sayers BMcA (1973) Analysis of heart rate variability.Ergonomics 16:17–32
Selman A, McDonald A, Kitney R, Linkens D (1982) The interaction between heart rate and respiration. I. Experimental studies in man.Automedica 4:131–139
Sibley DR, Lefkowitz RJ (1985) Molecular mechanisms of receptor desensitization using the beta-adrenergic receptor coupled adenylate cyclase system as a model.Nature 317:124–129
Van den Akker TJ, Koeleman ASM, Hogenhuis LAH, Rompelman O (1983) Heart rate variability and blood pressure oscillations in diabetics with autonomic neuropathy.Automedica 4:201–208
Weiner N (1930) Generalzed harmonic analysis.Acta Math 55:117–258
Whittaker ET, Watson GN (1952)A course of modern analysis, 4th edn. University Press, Cambridge, pp 160–193
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Gordon, D., Herrera, V.L., McAlpine, L. et al. Heart-rate spectral analysis: A noninvasive probe of cardiovascular regulation in critically ill children with heart disease. Pediatr Cardiol 9, 69–77 (1988). https://doi.org/10.1007/BF02083703
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DOI: https://doi.org/10.1007/BF02083703