Evaluation of the heart rate variability in cardiogenic vertigo patients

Abstract

Background: The detection of documented cardiac arrhythmias during vertigo attacks and vertigo resolution through the treatment of arrhythmias is defined as cardiogenic vertigo (CV). Aim and Objective: We evaluate the impact of arrhythmias on vertigo and assess the types of arrhythmias and heart rate variability using 24-h ambulatory electrocardiogram (Holter) monitoring. Patients and Methods: The study included 70 patients with CV. Demographic, clinical, and laboratory data were analyzed. Holter monitoring and echocardiography were conducted, and the results were analyzed. Results: The average age of the patient group was 46.7 ± 8.6 years, and the number of female patients (65.7%) was almost twice that of the number of male patients. Clinical features, such as thyroid dysfunction (4.2%), diabetes mellitus (22%), dyslipidemia (27.1%), hypertension (34%), iron deficiency anemia (5.7%), and smoking status (21.4%), were identified. Vertigo manifested in the presence of syncopal episodes in 18 (25.7%) patients, and 47 (67.1%) patients presented with spinning during the episodes. Most of the vertigo attacks were induced by standing in 27 patients (38.6%) and lasted for only a few seconds in 52 (74.2%) patients. In terms of the Holter monitoring records, tachycardia-bradycardia was the syndrome that was observed the most. The computed average low-to-high frequency ratio was 2.24 ± 1.6. Conclusion: This study showed that arrhythmias could increase the risk of vertigo attacks in patients with no known history of heart disease. The patients had significant autonomic nervous system dysfunction in favor of the sympathetic system.

Keywords

• arrhythmia
• heart rate variability
• holter monitoring
• syncope
• vertigo