• Muhammad Alamgir Khan Department of Physiology, Army Medical College, Rawalpindi, Pakistan
  • Syed Muhammad Imran Majeed Department of Clinical Cardiac Electrophysiology Armed Forces Institute of Cardiology/National Institute of Heart Diseases
  • Madiha Sarwar Department of Physiology, Foundation University Medical College, Rawalpindi
Keywords: heart rate variability, ambulatory ECG recording, holter monitoring, arrhythmias


Background: Heart rate variability represents oscillations in intervals between heart beats that is characterised as variable RR intervals on standard ECG. It provides information about autonomic as well as non-autonomic regulatory mechanisms in health and disease states. Reduced heart rate variability is considered a non-invasive marker of autonomic dysfunction that can predict wide range of cardio-pulmonary disorders leading to sudden cardiac death. The objective of this study was to compare heart rate variability recorded from 24 hours with that recorded from 72 hours of holter monitoring in healthy adults. Methods: Thirty-seven healthy voluntary adults were selected and holter monitored for 72 hours using Reynolds medical holter monitors ‘life card CF’. Statistical time domain parameters, i.e., SDNN, SDANN and RMSSD were calculated from 24 hours and 72 hours ambulatory ECG recordings. The data were analysed using SPSS-21. Paired sample t-test was used to compare the mean values of heart rate variability parameters. Results: Mean values of SDNN, SDANN and RMSSD from 24 hours holter monitoring were 141.62 ms, 125.16 ms, and 28.40 ms and those recorded from 72 hours of holter monitoring were 136.94 ms, 122.37 ms, and 26.46 ms respectively. Differences between none of the variables from the two recordings were statistically significant (p>0.05) Conclusion: Increase in duration of holter monitoring has no advantage on time domain parameters of heart rate variability in healthy individuals.

Pak J Physiol 2013;9(2):26–8


1. Chen HY. Relationship of heart rate turbulence, heart rate variability and the number of ventricular premature beats in patients with mitral valve prolapse and non-significant regurgitation. Int J Cardiol 2009;135(2):269–71.
2. Stauss HM. Heart rate variability. Am J Physiol Regul Integr Comp Physiol 2003;285(5):R927–31.
3. Gombojav B, Park H, Kim JI, Ju YS, Sung J, Cho SI, et al. Heritability and linkage study on heart rates in a Mongolian population. Exp Mol Med 2008;40(5):558–64.
4. Iravanian S, Arshad A, Steinberg JS. Role of electrophysiologic studies, signal-averaged electrocardiography, heart rate variability, T-wave alternans, and loop recorders for risk stratification of ventricular arrhythmias. Am J Geriatr Cardiol 2005;14(1):16–9.
5. Stein PK, BarzilayJI, Chaves PH, Mistretta SQ, Domitrovich PP, GottdienerJS, et al. Novel measures of heart rate variability predict cardiovascular mortality in older adults independent of traditional cardiovascular risk factors: the Cardiovascular Health Study (CHS). J Cardiovasc Electrophysiol 2008;19(11):1169–74.
6. Su S, Lampert R, Lee F, Bremner JD, Snieder H, Jones L, et al. Common genes contribute to depressive symptoms and heart rate variability: The Twins Heart Study. Twin Res 2010;13(1):1–9.
7. Thayer JF, Ahs F, Fredrikson M, Sollers JJ 3rd, Wager TD. A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health. Neurosci Biobehav Rev 2012;36(2):747–56.
8. De Jong MJ, Randall DC. Heart rate variability analysis in the assessment of autonomic function in heart failure. J Cardiovasc Nurs 2005;20(3):186–95.
9. Christensen JH, Schmidt EB. Autonomic nervous system, heart rate variability and n-3 fatty acids. J Cardiovasc Med 2007;8(Suppl 1):S19–22.
10. Hillebrand S, Gast KB, de Mutsert R, Swenne CA, Jukema JW, Middeldorp S, et al. Heart rate variability and first cardiovascular event in populations without known cardiovascular disease: meta-analysis and dose-response meta-regression. Europace 2013;15(5):742–9.
11. Bilchick KC, StukenborgGJ, Kamath S, Cheng A. Prediction of mortality in clinical practice for medicare patients undergoing defibrillator implantation for primary prevention of sudden cardiac death. J Am Coll Cardiol 2012;60(17):1647–55.
12. Koome ME, Bennet L, Booth LC, Wassink G, Davidson JO, Gunning M, et al. Quantifying the power spectrum of fetal heart rate variability. Exp Physiol 2014;99(2):468.
13. Huikuri HV, Stein PK. Heart rate variability in risk stratification of cardiac patients. Prog Cardiovasc Dis 2013;56(2):153–9.
14. Goya-Esteban R, Mora-Jimenez I, Rojo-Alvarez JL, Barquero-Perez O, Pastor-Perez FJ, Manzano-Fernandez S, et al. Heart rate variability on 7-day Holter monitoring using a bootstrap rhythmometric procedure. IEEE Trans Biomed Eng 2010;57(6):1366–76.
15. Ramaekers D, Ector H, Aubert AE, Rubens A, Van de Werf F. Heart rate variability and heart rate in healthy volunteers. Is the female autonomic nervous system cardioprotective? Eur Heart J 1998;19(9):1334–41.
16. Fu Q, Witkowski S, Okazaki K, Levine BD. Effects of gender and hypovolemia on sympathetic neural responses to orthostatic stress. Am J Physiol Regul Integr Comp Physiol 2005;289(1):R109–16.
17. Marina Medina Corrales BdlCT, Alberto Garrido Esquivel, Marco Antonio Garrido Salazar, José Naranjo Orellana. Normal values of heart rate variability at rest in a young, healthy and active Mexican population. Health 2012;4(7):377–85.
18. Kishi T. Heart failure as an autonomic nervous system dysfunction. J Cardiol 2010;35(3):229–42.
19. Wheat AL, Larkin KT. Biofeedback of heart rate variability and related physiology: a critical review. Appl Psychophysiol Biofeedback 2010;35(3):229–42.
20. Costa O, Lago P, Rocha AP, Carvalho MJ, Freitas A, Freitas J, et al. Heart rate variability in 24-hour Holter recordings. Comparative study between short- and long-term time- and frequency-domain analyses. J Electrocardiol 1994; 27(3):251–4.
21. Heilbron EL. Advances in modern electrocardiographic equipment for long-term ambulatory monitoring. Card Electrophysiol Rev 2002;6(3):185–9.
22. Nicolini P, Ciulla MM, De Asmundis C, Magrini F, Brugada P. The prognostic value of heart rate variability in the elderly, changing the perspective: from sympathovagal balance to chaos theory. Pacing Clin Electrophysiol 2012;35(5):622–38.


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Khan M, Majeed SM, Sarwar M. HEART RATE VARIABILITY: COMPARISON OF 24 HOURS WITH 72 HOURS HOLTER MONITORING IN HEALTHY ADULTS. PJP [Internet]. 31Dec.2013 [cited 6Jul.2020];9(2):26-8. Available from: http://pjp.pps.org.pk/index.php/PJP/article/view/385