Short-Term Effect of Percutaneous Coronary Intervention on Heart Rate Variability in Patients with Coronary Artery Disease

Myocardial ischemia in patients with coronary artery disease (CAD) leads to imbalanced autonomic control that increases the risk of morbidity and mortality. To systematically examine how autonomic function responds to percutaneous coronary intervention (PCI) treatment, we analyzed data of 27 CAD patients who had admitted for PCI in this pilot study. For each patient, five-minute resting electrocardiogram (ECG) signals were collected before and after the PCI procedure. The time intervals between ECG collection and PCI were both within 24 h. To assess autonomic function, normal sinus RR intervals were extracted and were analyzed quantitatively using traditional linear time- and frequency-domain measures [i.e., standard deviation of the normal-normal intervals (SDNN), the root mean square of successive differences (RMSSD), powers of low frequency (LF) and high frequency (HF) components, LF/HF] and nonlinear entropy measures [i.e., sample entropy (SampEn), distribution entropy (DistEn), and conditional entropy (CE)], as well as graphical metrics derived from Poincare plot [i.e., Porta's index (PI), Guzik's index (GI), slope index (SI) and area index (AI)]. Results showed that after PCI, AI and PI decreased significantly (p < 0.002 and 0.015, respectively) with effect sizes of 0.88 and 0.70 as measured by Cohen's d static. These changes were independent of sex. The results suggest that graphical AI and PI metrics derived from Poincare plot of short-term ECG may be potential for sensing the beneficial effect of PCI on cardiovascular autonomic control. Further studies with bigger sample sizes are warranted to verify these observations.