Precursors of syncope in linear and non-linear parameters of heart rate variability during pediatric head-up tilt test
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Abstract
The aim of this study was to identify precursors of neurocardiogenic syncope (NCS) in ECG parameters of children and adolescents who undergo head-up tilt testing (HUTT). Established linear and non-linear parameters of heart rate variability (HRV) were calculated minute-by-minute in 44 young patients with an NCS history (age 7–20 years, 22 female, 22 male, positive HUTT) and 34 age-matched healthy controls (age 7–20 years, 17 female, 17 male, negative HUTT) during 60° HUTT. The influence of age and gender on the response to tilting was studied using the Wilcoxon rank sum test. We also assessed the predictive power of individual features with respect to HUTT outcome within three temporal windows (0–2 min after tilt; 2–5 min after tilt, and 5–2 min before tilt-back) by means of receiver operating characteristics analysis. Our results indicate that prediction of HUTT outcome should be restricted to subjects in or after puberty. In this group, descriptors based on co-occurrence or joint-recurrence analysis in recurrence plots showed promising predictive power (up to 86% sensitivity and 90% specificity, area under the curve 0.91). Time-domain parameters (standard deviation of differences for successive RR intervals) reached 75% sensitivity and 80% specificity. We conclude that HRV analysis within the first 5 min after tilting provides significant information on HUTT outcome and may be useful in conjunction with more sophisticated classification strategies for shortening HUTT duration in subjects after puberty.
©2008 by Walter de Gruyter Berlin New York
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- Review
- Molekulare Signalwege der aseptischen Endoprothesenlockerung / Molecular pathways in aseptic loosening of orthopaedic endoprosthesis
- Research articles
- A novel transcutaneous vagus nerve stimulation leads to brainstem and cerebral activations measured by functional MRI / Funktionelle Magnetresonanztomographie zeigt Aktivierungen des Hirnstamms und weiterer zerebraler Strukturen unter transkutaner Vagusnervstimulation
- Brustvolumenbestimmung anhand der 3-D-Oberflächengeometrie: Verifizierung der Methode mit Hilfe der Kernspintomographie / Breast volume assessment based on 3D surface geometry: verification of the method using MR imaging
- Femoral stiffness and strength critically depend on loading angle: a parametric study in a mouse-inbred strain
- Osteosynthese am proximalen Humerus mittels winkelstabiler Platte oder Doppelplatte: eine vergleichende biomechanische Untersuchung / Angle-fixed plate fixation or double-plate osteosynthesis in fractures of the proximal humerus: a biomechanical study
- A robust optical respiratory trigger for small rodents in clinical whole-body MR systems / Ein robuster optischer Atemtrigger für Kleinsäuger in klinischen Ganzkörper-MR-Scannern
- Precursors of syncope in linear and non-linear parameters of heart rate variability during pediatric head-up tilt test
- Short communication
- Effects of poorly perfused peripheries on derived transit time parameters of the lower and upper limbs
- Letters to the editor
- Comments on “Vigilance monitoring – review and practical aspects”, by Sebastian Canisius and Thomas Penzel; Biomed Tech 2007; 52: 77–82
- Response to “Comments on ‘Vigilance monitoring – review and practical aspects’, by Sebastian Canisius and Thomas Penzel”; Biomed Tech 2008; 53: 160–161
Articles in the same Issue
- Review
- Molekulare Signalwege der aseptischen Endoprothesenlockerung / Molecular pathways in aseptic loosening of orthopaedic endoprosthesis
- Research articles
- A novel transcutaneous vagus nerve stimulation leads to brainstem and cerebral activations measured by functional MRI / Funktionelle Magnetresonanztomographie zeigt Aktivierungen des Hirnstamms und weiterer zerebraler Strukturen unter transkutaner Vagusnervstimulation
- Brustvolumenbestimmung anhand der 3-D-Oberflächengeometrie: Verifizierung der Methode mit Hilfe der Kernspintomographie / Breast volume assessment based on 3D surface geometry: verification of the method using MR imaging
- Femoral stiffness and strength critically depend on loading angle: a parametric study in a mouse-inbred strain
- Osteosynthese am proximalen Humerus mittels winkelstabiler Platte oder Doppelplatte: eine vergleichende biomechanische Untersuchung / Angle-fixed plate fixation or double-plate osteosynthesis in fractures of the proximal humerus: a biomechanical study
- A robust optical respiratory trigger for small rodents in clinical whole-body MR systems / Ein robuster optischer Atemtrigger für Kleinsäuger in klinischen Ganzkörper-MR-Scannern
- Precursors of syncope in linear and non-linear parameters of heart rate variability during pediatric head-up tilt test
- Short communication
- Effects of poorly perfused peripheries on derived transit time parameters of the lower and upper limbs
- Letters to the editor
- Comments on “Vigilance monitoring – review and practical aspects”, by Sebastian Canisius and Thomas Penzel; Biomed Tech 2007; 52: 77–82
- Response to “Comments on ‘Vigilance monitoring – review and practical aspects’, by Sebastian Canisius and Thomas Penzel”; Biomed Tech 2008; 53: 160–161
