Ischemic Stroke Risk Assessment by Multiscale Entropy Analysis of Heart Rate Variability in Patients with Persistent Atrial Fibrillation

Entropy

Eiichi Watanabe¹  Ken Kiyono²  Ghina Chairina³  Kohzoh Yoshino³ 

[1] Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya 454-8509, Japan;Graduate School of Engineering Science, Osaka University, Toyonaka 560-8531, Japan;Graduate School of Science and Technology, Kwansei Gakuin University, Sanda 669-1337, Japan;

关键词: atrial fibrillation;    ischemic stroke;    heart rate variability;    multiscale entropy;   

DOI  :  10.3390/e23070918

来源: DOAJ

【 摘 要 】

It has been recognized that heart rate variability (HRV), defined as the fluctuation of ventricular response intervals in atrial fibrillation (AFib) patients, is not completely random, and its nonlinear characteristics, such as multiscale entropy (MSE), contain clinically significant information. We investigated the relationship between ischemic stroke risk and HRV with a large number of stroke-naïve AFib patients (628 patients), focusing on those who had never developed an ischemic/hemorrhagic stroke before the heart rate measurement. The ${\mathrm{CHA}}_2{\mathrm{DS}}_2-\mathrm{VASc}$ score was calculated from the baseline clinical characteristics, while the HRV analysis was made from the recording of morning, afternoon, and evening. Subsequently, we performed Kaplan–Meier method and cumulative incidence function with mortality as a competing risk to estimate the survival time function. We found that patients with sample entropy ($S_E^{\left(s\right)}$) $\ge$ 0.68 at 210 s had a significantly higher risk of an ischemic stroke occurrence in the morning recording. Meanwhile, the afternoon recording showed that those with $S_E^{\left(s\right)}$ $\ge$ 0.76 at 240 s and $S_E^{\left(s\right)}$ $\ge$ 0.78 at 270 s had a significantly lower risk of ischemic stroke occurrence. Therefore, $S_E^{\left(s\right)}$ at 210 s (morning) and 240 s ≤ s ≤ 270 s (afternoon) demonstrated a statistically significant predictive value for ischemic stroke in stroke-naïve AFib patients.

【 授权许可】

Unknown