August 4, 2008 – New research shows abnormal heart rate turbulence (HRT), an ECG-based risk marker, is a significant risk predictor for sudden death in patients with congestive heart failure (CHF).
The study published in the August edition of the HeartRhythm Journal, the official journal of the Heart Rhythm Society, is the first to document abnormal HRT as an indicator of sudden, or arrhythmic death risk in patients with heart failure.
The MUSIC (Muerte Subita en Insufficiencia Cardiaca) Study, a multi-center, Spanish, longitudinal study designed to assess risk markers for sudden death in CHF patients, represents the largest heart failure population ever studied. More than 1,000 patients were enrolled in the MUSIC Study between 2003 and 2004 and several risk markers, including Holter-based, were assessed to predict mortality during nearly four years of follow up. Led by principal investigator Antoni Bayes de Luna, M.D., this is the first study to document that HRT predicts not only all-cause mortality and heart failure progression, but also sudden death in patients with heart failure.
“Our study documented that HRT might be considered a useful tool to identify heart failure patients at high risk of death, including high risk of dying suddenly,” said lead author Iwona Cygankiewicz, M.D., Ph.D., cardiology division, University of Rochester Medical Center in New York. “HRT may help physicians more effectively manage heart failure patients by indicating the need for more frequent follow up visits at specialized heart failure units and more intensely applied therapy, including ICD implantation in high risk patients.”
About 50 percent of congestive heart failure-related deaths are due to progressive heart failure, while the other half are thought to be related to serious arrhythmias. Even though HRT was proven as an important risk startifier in postinfarction patients, little is known about its value in patients with heart failure. Previous, smaller studies have proven abnormal HRT as a risk stratifier for all-cause mortality and heart failure progression, but not sudden death.
Patients of the MUSIC study represent a modern population of heart failure patients with a broad spectrum of etiologies. The study population includes patients with heart failure as seen at the ambulatory practice, including a high number of patients with preserved left ventricular ejection fraction (LVEF). Interest is growing in the survival of patients with preserved LVEF and the MUSIC study marks the first time this subgroup was included in a study evaluating the prognostic value of HRT.
For more information: www.heartrhythmjournal.com
May 06, 2026 
