Effect of Clonidine on heart rate variability in congestive heart failure

Ihab Girgis, Simon Chakko, Eduardo De Marchena, Cesar Jara, Pablo Diaz, Agustin Castellanos, Robert J Myerburg

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

In patients with congestive heart failure, abnormal heart rate variability is a predictor of total mortality and sudden cardiac death. Drugs that improve heart rate variability may have a potential role for improving the survival among these patients. The effects of clonidine were studied in 24 patients with congestive heart failure, sinus rhythm, a left ventricular ejection fraction <0.40, and systolic blood pressure > 115 mm Hg. A 6-minute corridor walk test and 24-hour Holter monitoring were performed before and 42 ± 24 days after initiation of clonidine therapy (Catapres-TTS patch, mean dose: 0.33 ± 0.21 mg). Changes in other medications used at baseline were not allowed. One patient died suddenly. Two patients did not complete the protocol due to worsening congestive heart failure, which required changes in medications, 1 patient discontinued due to hypotension, and 2 for personal reasons. Among the 18 patients who completed the protocol, the mean RR interval of sinus beats increased from 760 ± 106 to 822 ± 125 ms (p = 0.001) and the distance covered during the 6-minute walk test increased from 1,148 ± 277 to 1,255 ± 359 feet (p = 0.042). Systolic blood pressure decreased from 139 ± 15 to 119 ± 10 mm Hg (p <0.0001). The following increases were noted in the heart rate variability measurements: high- frequency power in 0.15 to 0.40 Hz: 4.58 ± 1.07 to 4.94 ±1.17 In (ms), p = 0.002; SD: 47.0 ± 16.9 to 52.5 ± 18.4 ms, p = 0.034; SD of the mean of all RR intervals in 24 hours: 116 ± 94 to 130 ± 19 ms, p = 0.033; SD of all 5- minute mean RR intervals: 106 ± 44 to 124 ± 66 ms, p = 0.042; root-mean square of difference of successive RR intervals: 28.8 ± 10.7 to 34.1 ± 14.2 ms, p = 0.017. Clonidine improves heart rate variability in the patients with congestive heart failure by increasing the parasympathetic tone. It is well tolerated by most patients with heart failure and may have a beneficial effect on exercise capacity.

Original languageEnglish
Pages (from-to)335-337
Number of pages3
JournalAmerican Journal of Cardiology
Volume82
Issue number3
DOIs
StatePublished - Aug 17 1998
Externally publishedYes

Fingerprint

Clonidine
Heart Failure
Heart Rate
Blood Pressure
Ambulatory Electrocardiography
Sudden Cardiac Death
Stroke Volume
Hypotension
Exercise
Survival
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effect of Clonidine on heart rate variability in congestive heart failure. / Girgis, Ihab; Chakko, Simon; De Marchena, Eduardo; Jara, Cesar; Diaz, Pablo; Castellanos, Agustin; Myerburg, Robert J.

In: American Journal of Cardiology, Vol. 82, No. 3, 17.08.1998, p. 335-337.

Research output: Contribution to journalArticle

Girgis, Ihab ; Chakko, Simon ; De Marchena, Eduardo ; Jara, Cesar ; Diaz, Pablo ; Castellanos, Agustin ; Myerburg, Robert J. / Effect of Clonidine on heart rate variability in congestive heart failure. In: American Journal of Cardiology. 1998 ; Vol. 82, No. 3. pp. 335-337.
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