Aditya Menon

Moldova

Heart Rate Variability as a Predictor of Sudden Cardiac Death in Chronic Disease in Children.

Aditya Menon1, Romancuic Lilia1
Department of Pediatrics ,USMF, Moldova

Abstract

Background

Heart rate variability represents the variability in time intervals between consecutive heartbeats and, as such, it reflects the activity of the autonomic nervous system, the balance between the sympathetic and parasympathetic branches of the nervous system. Decreased HRV is a reflection of lower autonomic regulation and has been related to an increased risk of developing adverse cardiovascular events, including sudden cardiac death. Indeed, chronic diseases, especially cardiovascular ones, such as heart failure and arrhythmias are known to impact autonomic function and, consequently, HRV. HRV has been hyped as a possible non-invasive tool for SCD prediction, which still represents a significant concern among patients with long-term health conditions.

Methods

The bibliographic sources included in the study were based on online resources published between 2014 and 2024, including PubMed, Google Scholar, Science Direct, and others.

Results

Association between decreased HRV and increased SCD risk has been stated by many studies in the setting of Chronic heart diseases, Heart Failure, Congenital Heart diseases and other long-term diseases. Reduced HRV in children is an indicator of impaired autonomic regulation and is linked with arrhythmic events and increased mortality. In patients with heart failure, HRV proved to be an independent predictor of sudden death; in diabetic subjects, low HRV has been associated with increased cardiac risk and development of cardiovascular diseases. The parameters commonly used for quantification of HRV include standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive differences (RMSSD), both showing predictive value regarding mortality in these populations.

Conclusions

HRV is an emerging tool, capable of predicting sudden cardiac death in patients with chronic diseases. Non-invasive, due to its reflection concerning autonomic dysfunction, it poses a very important tool as a biomarker. Although the measurements of HRV do not substitute other clinical risk stratification assessments, these could possibly provide substantial supplemental risk-stratifying information concerning the clinical decision-making aspect. Further prospective studies are needed to refine the thresholds for HRV-based risk prediction and to better integrate HRV assessment into clinical practice for chronic disease management.