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Master Thesis

MisMi HRV : évaluation de la variabilité de la fréquence cardiaque comme paramètre de suivi chez les personnes âgées et/ou fragiles en EHPAD

Abstract : Introduction: Early management of episodes of clinical deterioration in the frail elderly would certainly prevent hospitalisation, reduce mortality and slow the loss of autonomy. Heart rate variability is modified early in certain pathological circumstances. To our knowledge, close monitoring of heart rate variability has never been performed in the elderly and seemed relevant. Materials and methods: The study was conducted in two nursing homes in the Rhône Alpes region. Monitoring was performed twice a week, in the morning in decubitus position, using a high-precision ECG over a period of five minutes. Patients with a pacemaker or permanent atrial fibrillation were excluded. The main objective of the study was to observe the evolution of the different parameters of cardiac variability and to compare them with the clinical evolution of the patient. The evaluation of the acceptability of the device by the patients was done by questionnaire. Results: A total of 18 patients aged 85 years on average were included, which is far from the objective of the study which was 44 inclusions. 191 measurements were performed, of which only 101 allowed the calculation of heart rate variability parameters, the other measurements had to be rejected because of poor quality tracings and/or rhythm disorders. We noted a clear and early drop in heart rate variability parameters during a severe pneumopathy. During the other episodes of clinical deterioration observed, the calculation of heart rate variability parameters was not possible. Acceptability was poor, even if the patients were satisfied to have participated in the study, only one out of two envisaged continuing the protocol in the long term. Discussion: The frequency of rhythm disorders, the lack of cooperation from patients and the working conditions in nursing homes impact the quality of the tracings and often make it impossible to calculate heart rate variability parameters. Acceptability by patients could possibly be improved if the measurement was carried out by a device worn permanently such as a connected watch, even though the accuracy of these devices is not currently sufficient. Conclusion: The characteristics of the population studied as well as the working conditions in the nursing home clearly limit the interest of using cardiac variability as a monitoring parameter.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03371469
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Friday, October 8, 2021 - 4:25:45 PM
Last modification on : Sunday, October 10, 2021 - 3:22:31 AM

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  • HAL Id : dumas-03371469, version 1

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Thibaut Verjux. MisMi HRV : évaluation de la variabilité de la fréquence cardiaque comme paramètre de suivi chez les personnes âgées et/ou fragiles en EHPAD. Médecine humaine et pathologie. 2021. ⟨dumas-03371469⟩

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