Heikki V. Huikuri
Oulu University Hospital
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Featured researches published by Heikki V. Huikuri.
American Journal of Cardiology | 2001
Timo H. Mäkikallio; Heikki V. Huikuri; Jorgen Videbæk; Raul D. Mitrani; Agustin Castellanos; Robert J. Myerburg; Mogens Møller
Time-domain measures of heart rate (HR) variability provide prognostic information among patients with congestive heart failure (CHF). The prognostic power of spectral and fractal analytic methods of HR variability has not been studied in the patients with chronic CHF. The aim of this study was to assess whether traditional and fractal analytic methods of HR variability predict mortality among a population of patients with CHF. The standard deviation of RR intervals, HR variability index, frequency-domain indexes, and the short-term fractal scaling exponent of RR intervals were studied from 24-hour Holter recordings in 499 patients with CHF and left ventricular ejection fraction < or =35%. During a mean follow-up of 665 +/- 374 days, 210 deaths (42%) occurred in this population. Conventional and fractal HR variability indexes predicted mortality by univariate analysis. For example, a short-term fractal scaling exponent <0.90 had a risk ratio (RR) of 1.9 (95% confidence interval [CI] 1.4 to 2.5) and the SD of all RR intervals <80 ms had an RR of 1.7 (95% CI 1.2 to 2.1). After adjusting for age, functional class, medication, and left ventricular ejection fraction in the multivariate proportional-hazards analysis, the reduced short-term fractal exponent remained the independent predictor of mortality, RR 1.4 (95% CI 1.0 to 1.9; p <0.05). All HR variability indexes were more significant univariate predictors of mortality in functional class II than in class III or IV. Among patients with moderate heart failure, HR variability measurements provide prognostic information, but all HR variability indexes fail to provide independent prognostic information in patients with the most severe functional impairment.
American Journal of Cardiology | 2002
Jari M. Tapanainen; Poul Erik Bloch Thomsen; Lars Køber; Christian Torp-Pedersen; Timo H. Mäkikallio; Aino-Maija Still; Kai S. Lindgren; Heikki V. Huikuri
The recently developed fractal analysis of heart rate (HR) variability has been suggested to provide prognostic information about patients with heart failure. This prospective multicenter study was designed to assess the prognostic significance of fractal and traditional HR variability parameters in a large, consecutive series of survivors of an acute myocardial infarction (AMI). A consecutive series of 697 patients were recruited to participate 2 to 7 days after an AMI in 3 Nordic university hospitals. The conventional time-domain and spectral parameters and the newer fractal scaling indexes of HR variability were analyzed from 24-hour RR interval recordings. During the mean follow-up of 18.4 +/- 6.5 months, 49 patients (7.0%) died. Of all the risk variables, a reduced short-term fractal scaling exponent (alpha(1) <0.65), measured by detrended fluctuation analysis, was the most powerful predictor of mortality (univariate relative risk 5.05, 95% confidence intervals [CI] 2.87 to 8.89, p <0.001). A low scaling exponent alpha(1) predicted death in the patients with and without depressed left ventricular function (p <0.001 and p <0.01, respectively). Several other HR variability parameters also predicted mortality in univariate analyses, but in a multivariate analysis after adjustments for clinical variables and left ventricular ejection fraction, alpha(1) was the most significant independent HR variability index that predicted subsequent mortality (relative risk 3.90, 95% CI 2.03 to 7.49, p <0.001). Short-term fractal scaling analysis of HR variability is a powerful predictor of mortality among patients surviving an acute myocardial infarction.
Journal of Cardiovascular Electrophysiology | 2001
Jari M. Tapanainen; Aino-Maija Still; K.E.Juhani Airaksinen; Heikki V. Huikuri
Noninvasive Risk Assessment Including TWA After AMI. Introduction: Occurrence of sustained microvolt‐level T wave alternans (TWA) at a specified heart rate has been suggested to predict life‐threatening arrhythmic events, but its prognostic value has not been well established in patients who survived an acute myocardial infarction (AMI). The purpose of this prospective study was to assess the predictive significance of various noninvasive risk indicators of mortality, including TWA, in consecutive post‐AMI patients with optimized medical therapy.
Europace | 2016
Charles Antzelevitch; Gan Xin Yan; Michael J. Ackerman; Martin Borggrefe; Domenico Corrado; Jihong Guo; Ihor Gussak; Can Hasdemir; Minoru Horie; Heikki V. Huikuri; Changsheng Ma; Hiroshi Morita; Gi Byoung Nam; Frédéric Sacher; Wataru Shimizu; Sami Viskin; Arthur A.M. Wilde
The J-wave syndromes (JWSs), consisting of the Brugada syndrome (BrS) and early repolarization syndrome (ERS), have captured the interest of the cardiology community over the past 2 decades following the identification of BrS as a new clinical entity by Pedro and Josep Brugada in 1992.[1][1] The
Heart Rhythm | 2016
Charles Antzelevitch; Gan Xin Yan; Michael J. Ackerman; Martin Borggrefe; Domenico Corrado; Jihong Guo; Ihor Gussak; Can Hasdemir; Minoru Horie; Heikki V. Huikuri; Changsheng Ma; Hiroshi Morita; Gi Byoung Nam; Frédéric Sacher; Wataru Shimizu; Sami Viskin; Arthur A.M. Wilde
J-Wave syndromes expert consensus conference report: Emerging concepts and gaps in knowledge Charles Antzelevitch, PhD, FHRS, Gan-Xin Yan, MD, PhD, Michael J. Ackerman, MD, PhD, Martin Borggrefe, MD, Domenico Corrado, MD, PhD, Jihong Guo, MD, Ihor Gussak, MD, PhD, Can Hasdemir, MD, Minoru Horie, MD, Heikki Huikuri, MD, Changsheng Ma, MD, Hiroshi Morita, MD, PhD, Gi-Byoung Nam, MD, PhD, Frederic Sacher, MD, PhD, Wataru Shimizu, MD, PhD, Sami Viskin, MD, Arthur A.M. Wilde, MD, PhD, FHRS
American Journal of Cardiology | 1998
Agustin Castellanos; Federico Moleiro; Simon Chakko; Helbert Acosta; Heikki V. Huikuri; Raul D. Mitrani; Robert J. Myerburg
Analysis of heart rate variability in patients with inappropriate sinus tachycardia showed a 24-hour decrease in all temporal and spectral indexes, even after attempted correction to a rate of 75 beats/min. This may have resulted from a global decrease in parasympathetic activity or from a rapid sinus rate produced by other ill-defined mechanisms.
Heart Rhythm | 2011
Christian Jons; Uffe G. Jacobsen; Rikke Moerch Joergensen; Niels Thue Olsen; Ulrik Dixen; Arne Johannessen; Heikki V. Huikuri; Marc Messier; Scott McNitt; Poul Erik Bloch Thomsen
BACKGROUND The incidence and risk associated with new-onset atrial fibrillation (AF) occurring after discharge in patients with acute myocardial infarction (MI) remains unknown. OBJECTIVE This study sought to describe the incidence and clinical risk associated with postdischarge new-onset AF in post-MI patients with left ventricular systolic dysfunction. METHODS The population included 271 post-MI patients with left ventricular ejection fraction ≤ 40% and no history of previous AF from the Cardiac Arrhythmias and Risk Stratification after Acute Myocardial Infarction (CARISMA) study. All patients were implanted with an implantable cardiac monitor and followed up every 3 months for 2 years. Major cardiovascular events were defined as reinfarction, stroke, hospitalization for heart failure, or death. RESULTS The risk of new-onset AF is highest during the first 2 months after the acute MI (16% event rate) and decreases until month 12 post-MI, after which the risk for new-onset AF is stable. The risk of major cardiovascular events was increased in patients with AF events ≥ 30 seconds (hazard ratio [95% CI] = 2.73 [1.35 to 5.50], P = .005), but not in patients with AF events lasting <30 seconds (hazard ratio [95% CI] = 1.17 [0.35 to 3.92], P = .80). More than 90% of all recorded AF events were asymptomatic. CONCLUSION Using an implantable cardiac monitor, the incidence of new-onset AF was found to be 4-fold higher than earlier reported. In the study population, in which treatment with beta-blockers was optimized, the vast majority of AF events were asymptomatic, emphasizing the importance of using continuous monitoring for studies concerning AF in heart failure patients. A duration of 30 seconds or more identified clinically important AF episodes documented by an implantable cardiac monitor.
Frontiers in Physiology | 2015
Erik Fung; Marjo-Riitta Järvelin; Rahul N. Doshi; Jerold S. Shinbane; Steven Carlson; Luanda Grazette; Philip M. Chang; Rajbir S. Sangha; Heikki V. Huikuri; Nicholas S. Peters
Cardiac electrophysiologic derangements often coexist with disorders of the circulatory system. Capturing and diagnosing arrhythmias and conduction system disease may lead to a change in diagnosis, clinical management and patient outcomes. Standard 12-lead electrocardiogram (ECG), Holter monitors and event recorders have served as useful diagnostic tools over the last few decades. However, their shortcomings are only recently being addressed by emerging technologies. With advances in device miniaturization and wireless technologies, and changing consumer expectations, wearable “on-body” ECG patch devices have evolved to meet contemporary needs. These devices are unobtrusive and easy to use, leading to increased device wear time and diagnostic yield. While becoming the standard for detecting arrhythmias and conduction system disorders in the outpatient setting where continuous ECG monitoring in the short to medium term (days to weeks) is indicated, these cardiac devices and related digital mobile health technologies are reshaping the clinician-patient interface with important implications for future healthcare delivery.
PLOS ONE | 2015
Aki Juhani Käräjämäki; Olli-Pekka Pätsi; Markku J. Savolainen; Y. Antero Kesäniemi; Heikki V. Huikuri; Olavi Ukkola
Non-alcoholic fatty liver disease (NAFLD) and atrial fibrillation (AF) are widespread diseases and have multiple common risk factors and comorbidities. No studies of association between ultrasonography-diagnosed NAFLD and AF exist in other than diabetic population. The goal of this prospective study was to study the value of NAFLD as a predictor of atrial fibrillation. This study had 958 subjects from the OPERA (Oulu Project Elucidating Risk of Atherosclerosis) cohort, and the mean follow-up time was 16.3 years. NAFLD was diagnosed if the subject had fatty liver in ultrasonography and no excess alcohol intake. AF was followed in the National Registers. In this study 249 subjects (26.0%) had NAFLD and 37 (14.9%) of these had AF whereas only 56 (7.9%) of those without NAFLD experienced AF during the follow-up time (p = 0.001). In the multiple Cox regression analysis including potential confounders (age, sex, study group, diabetes, body mass index (BMI), waist circumference, alcohol consumption, smoking, serum alanine aminotransferase concentration (ALT), systolic blood pressure, quick index, left ventricular mass index, left atrial diameter, coronary artery disease (CAD), atrial natriuretic peptide (ANP) and high sensitive C-reactive protein (hs-CRP)), NAFLD remained as an independent predictor of AF (Adjusted OR, 1.88 (95% Confidence interval (CI) 1.03–3.45)). In conclusion, our data shows that NAFLD is independently associated with the risk of AF.
American Journal of Cardiology | 2002
T. Laitio; Timo H. Mäkikallio; Heikki V. Huikuri; Erkki Kentala; Pekka Uotila; J. Jalonen; Hans Helenius; Jaakko Hartiala; Sinikka Yli-Mäyry; Harry Scheinin
Postoperative myocardial ischemia is a common finding after coronary artery bypass grafting (CABG) and is associated with an adverse short-term clinical outcome. The reasons and pathophysiologic background for the occurrence of ischemia after CABG are not well established. We tested the hypothesis that altered heart rate (HR) behavior precedes the onset of myocardial ischemic episodes in patients after CABG. Time-domain HR variability measurements, along with analysis of Poincaré plots and fractal scaling analysis were assessed in 40 CABG patients from 48-hour postoperative Holter recordings. Twenty patients experienced 195 ischemic episodes during the postoperative course. In the univariate analysis of HR variability measurements of the first postoperative day (POD), the increased ratio between the short-term (SD1) and long-term (SD2) HR variability analyzed from the Poincaré plot and the decreased short- and intermediate-term fractal scaling exponents alpha(1) and alpha(2) were significantly associated with ischemia during the study period (p <0.01, p <0.05, and p <0.05, respectively). In the multivariate model, the increased SD1/SD2 ratio of the first POD was the most powerful independent predictor of all possible confounding variables for the occurrence of postoperative ischemia (corresponding to a change of 0.15 U; odds ratio 2.2 and 95% confidence interval 1.2 to 5.7; p <0.01). Altered HR dynamics have been associated with myocardial ischemic episodes in patients after CABG, suggesting that the autonomic nervous system has an important role in the pathogenesis of myocardial ischemia in the postoperative phase of CABG.