Mortality Risk Stratification in Heart Failure. The Search for the Holy Grail Continues! Autonomic Nervous System Analysis is Back!

Gomes et al. described an interesting study showing that the analysis of the autonomic nervous system (ANS) should participate in the prognostic assessment of patients with heart failure (HF). A new form of sympathetic assessment was analyzed, measuring 10-minute intervals of heart rate variability (HRV) in the time domain on 24-hour Holters of hospitalized patients, predominantly with HF.

The clinical relevance of the work lies in revealing that the evaluation of short-term HRV variables is one of the main parameters, as it detect brief moments of increased sympathetic tone, that seems to be more associated with HF decompensation and an increase in sudden cardiac death (SCD), adding a parameter (smallest rMSSD) to a risk prediction model that includes age > 69 years and ejection fraction (EF) <57%, with good accuracy.

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