Dynamic analysis of ventricular repolarization duration from 24-hour Holter recordings

Evaluation of the influence of the autonomic nervous system on the ventricular repolarization duration was carried out using beat-to-beat analysis of the time intervals between the peaks of the R and T waves (RTm). After pre-processing of digitized Holter ECG´s, auto and cross spectrum analyses were applied to heart rate and repolarization duration variability signals. Coherence analysis was used to assess the existence of common spectral contributions. The heart rate variability signal was used as reference of the sympatho-vagal balance at the sinus node. It was found that, in normal individuals, the autonomic nervous system directly influences the ventricular repolarization duration and that this influence is qualitatively very similar to the one that modulates the heart rate. Pathological alteration of these parallel autonomic activities to the heart (on the sinus node and on the ventricle) might cause uncoupling between depolarization and repolarization.