63104 20181123104100.0 doi 10.1109/CIC.2015.7411043 sideral 94688 ART-2016-94688 eng (orcid)0000-0003-0226-4950 Martín-Yebra, Alba Circadian modulation on T-wave alternans activity in chronic heart failure patients 2016 Access copy available to the general public Unrestricted Average TWA activity has been shown to be an independent predictor of sudden cardiac death (SCD) in chronic heart failure (CHF) patients. However, the influence of circadian rhythms on TWA remains understudied. In this work, we assessed circadian TWA changes in a CHF population and evaluated whether the prognostic value of TWA indices is sensitive to the circadian pattern. Holter ECG recordings from 626 consecutive CHF patients (52 SCD) were analyzed. The index of average alternans (IAA), quantifying the average TWA level, was measured in 4 consecutive 6-hour intervals using a multilead fully-automated method. Survival analysis was performed considering SCD as an independent endpoint. IAA changed along the day, with statistically significant lower values during the night than during daytime. This pattern is similar to the one observed in the mean heart rate (HR). However, a low correlation (r=.18) was found between IAA and HR in windows of 128 beats. After dichotomization of patients based on the third quartile of IAA indices, IAA indices computed between hours 06-12 (IAA06-12) and 18-24 (IAA18-24) successfully predicted SCD (Hazard Ratio, HaR:2.34(1.33-4.13)per µV, andHaR:1.87(1.04-3.36) per µV, respectively). In conclusion, circadian variation should be considered for SCD risk prediction. info:eu-repo/grantAgreement/ES/DGA/T96 info:eu-repo/grantAgreement/ES/MINECO/TEC2013-42140-R info:eu-repo/semantics/openAccess by http://creativecommons.org/licenses/by/3.0/es/ info:eu-repo/semantics/conferenceObject info:eu-repo/semantics/publishedVersion Caiani, Enrico G. (orcid)0000-0003-3434-9254 Laguna, Pablo Universidad de Zaragoza Monasterio, Violeta (orcid)0000-0002-7503-3339 Martínez, Juan Pablo Universidad de Zaragoza 5008 800 Universidad de Zaragoza Dpto. Ingeniería Electrón.Com. Área Teoría Señal y Comunicac. 42 (2016), 845-848 Comput. cardiol. Computing in Cardiology 2325-8861 634384 http://zaguan.unizar.es/record/63104/files/texto_completo.pdf Versión publicada 108049 http://zaguan.unizar.es/record/63104/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:63104 articulos driver 2018-11-23-10:32:51 ARTICLE