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

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...

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Bibliographic Details
Published in:Entropy (Basel, Switzerland) Switzerland), 2021-07, Vol.23 (7), p.918
Main Authors: Chairina, Ghina, Yoshino, Kohzoh, Kiyono, Ken, Watanabe, Eiichi
Format: Article
Language:English
Subjects:
atrial fibrillation
Cardiac arrhythmia
Cardiomyopathy
Cardiovascular disease
Coronary vessels
Diabetes
Electrocardiography
Entropy
Fibrillation
Heart failure
Heart rate
heart rate variability
Hypertension
ischemic stroke
Morning
multiscale entropy
Patients
Probability
Probability distribution
Recording
Risk assessment
Standard deviation
Stroke
Time functions
Time series
Transient ischemic attack
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Summary: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 CHA2DS2−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 (SE(s)) ≥ 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 SE(s) ≥ 0.76 at 240 s and SE(s) ≥ 0.78 at 270 s had a significantly lower risk of ischemic stroke occurrence. Therefore, SE(s) 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.
ISSN:1099-4300
1099-4300
DOI:10.3390/e23070918