Abstract

To the Editor: Wichterle et al recently presented in this journal a novel parameter of heart rate variability called prevalent low-frequency oscillation of heart rate (PLF).1 Using 2 groups of postinfarction patients derived from the EMIAT (European Myocardial Infarction Amiodarone Trial) and ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) studies, they specifically compared and showed a predictive value for PLF that was stronger than that for heart rate turbulence (HRT) parameters using univariate analysis. They further showed that with Cox’s multivariate regression model, the relative risk for PLF remained high (4.6 and 3.6 in EMIAT and ATRAMI, respectively), whereas HRT parameters turbulence slope and turbulence onset lost their independence. Their study is noteworthy because in previous comparisons of measures of HRT and heart rate variability in large studies, HRT has consistently outperformed heart rate variability.2–4 We would like to point out that the prognostic ability of risk factors is changing significantly with declining mortality from acute ischemic events as a …

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