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Am J Physiol Heart Circ Physiol (November 24, 2004). doi:10.1152/ajpheart.00785.2004
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Submitted on August 3, 2004
Accepted on November 18, 2004

Heart Rate Recovery Following Exercise: A Predictor of Ventricular Fibrillation Susceptibility After Myocardial Infarction

Lauren L Smith1, Monica Kukielka1, and George E Billman1*

1 Department of Physiology and Cell Biology, The Ohio State University, Columbus, Ohio, USA

* To whom correspondence should be addressed. E-mail: billman.1{at}osu.edu.

Heart rate recovery (HRR) after exercise, thought to be related to cardiac parasympathetic tone, has been shown to be a prognostic tool for all-cause mortality. However, the relationship between this variable and confirmed susceptibility to ventricular fibrillation (VF) has not been established. Therefore, myocardial ischemia was induced by a 2 min occlusion of the left circumflex artery during the last min of exercise in mongrel dogs with myocardial infarction (n=105). Ventricular fibrillation was induced in 66 (S, susceptible) animals while the remaining 39 dogs had no arrhythmias (R, resistant). On a previous day, ECG was recorded and time series analysis of heart rate variability (HRV) was measured 30, 60, and 120 s after submaximal exercise (treadmill running). The HRR was significantly greater in resistant dogs than in susceptible dogs at all three times, with the most dramatic difference at the 30 s mark (R= 48.1 ± 3.6, S= 31.0 ± 2.2 beats per minute, change from maximum). Correspondingly, indices of parasympathetic tone increased to a significantly greater extent in resistant dogs at 30 s and 60 s post-exercise. These differences were eliminated by atropine pretreatment. When considered together, these data suggest that resistant animals exhibit a more rapid recovery of vagal activity after exercise than those susceptible to VF. As such, post-exercise HRR may help identify patients with a high risk for VF following myocardial infarction.




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