Heart rate variability in neurosurgical patients

T. J. Leipzig, R. I. Lowensohn

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Cardiac monitors determine heart rate by counting the number of beats in a given time interval. The normal heart, however, does not beat at a constant rate. Instead, there is a continuous change in heart rate on a beat-by-beat basis. This is termed instantaneous heart rate and it represents the projected rate per minute that the heart would beat if only one R-R interval (the time between sequential R waves) was repeated throughout a 60-second period. Calculation of the instantaneous heart rate for each heart beat (R-R interval) produces a pattern that demonstrates the variability in heart rate. This instantaneous heart rate pattern was prospectively studied in 102 patients admitted to a neurosurgical intensive care unit. Short-term (STV) and long-term (LTV) heart rate variability were compared to the Glasgow coma scale as a method for patient assessment. LTV seems to be the most useful heart rate parameter in the clinical setting, and both STV and LTV performed better in the serial evaluation of patients. Two postulations found in the heart rate literature were not borne out in this study. First, we did not find a strong correlation between elevated intracranial pressure and decreases in heart rate or variability, as previously reported by Lowensohn et al. Second, the morphological classification of heart rate patterns described by Evans in his study of head-injured patients did not carry the same prognostic value when applied to this broad spectrum of patients with a variety of acute neurological disorders. Heart rate and its variability is a simple parameter to monitor. In comparison to multimodality evoked potential testing, heart rate monitoring is quicker, less cumbersome, and requires less technical skill. It can provide useful clinical information, especially for frequent serial examination of brain stem-injured patients. Periodicity in the heart rate pattern was noted in 33% of the patients studied. This technique may provide valuable information about postulated brain stem oscillatory centers governing heart rate, and it should be useful in the future investigation of neurocardiac interrelationships.

Original languageEnglish (US)
Pages (from-to)356-362
Number of pages7
JournalNeurosurgery
Volume19
Issue number3
StatePublished - 1986
Externally publishedYes

Fingerprint

Heart Rate
Brain Stem
Glasgow Coma Scale
Intracranial Hypertension
Periodicity
Nervous System Diseases
Evoked Potentials
Intensive Care Units
Head

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Leipzig, T. J., & Lowensohn, R. I. (1986). Heart rate variability in neurosurgical patients. Neurosurgery, 19(3), 356-362.

Heart rate variability in neurosurgical patients. / Leipzig, T. J.; Lowensohn, R. I.

In: Neurosurgery, Vol. 19, No. 3, 1986, p. 356-362.

Research output: Contribution to journalArticle

Leipzig, TJ & Lowensohn, RI 1986, 'Heart rate variability in neurosurgical patients', Neurosurgery, vol. 19, no. 3, pp. 356-362.
Leipzig TJ, Lowensohn RI. Heart rate variability in neurosurgical patients. Neurosurgery. 1986;19(3):356-362.
Leipzig, T. J. ; Lowensohn, R. I. / Heart rate variability in neurosurgical patients. In: Neurosurgery. 1986 ; Vol. 19, No. 3. pp. 356-362.
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