HRV scaling exponent identifies post-infarction patients who might benefit from prophylactic treatment with amiodarone

Analysing the Holter recordings collected at baseline during the European Myocardial Infarction Amiodarone Trial (EMIAT), we evaluate the possibility of using a, the slope of the power spectrum of heart rate variability signals (HRV) in the vicinity of f = 0, for postinfarction risk stratification. We found no relevant difference in the values of α for the placebo population. On the contrary, in the amiodarone arm, the distinction in the survival rates of those with high or low α-values was highly significant. Moreover, high risk patients with respect to α (higher values) did not seem to benefit from amiodarone. The results suggest that α might convey physiologic information that is different than what is expressed by other HRV characteristics, such as the triangular index. When combining high risk patients in term of triangular index (<20) and low risk patients with respect to α (