ArticleHeart rhythm2025
Power-law properties of nocturnal arrhythmia avalanches: A novel marker for incident cardiovascular events.
Article in Heart rhythm, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Empirically constrained order parameter dynamics in cardiovascular criticality: a synergetic Langevin framework for arrhythmic transitions with cross-cohort parameter estimation and Kramers escape-time validation.Frontiers in network physiology · 2026Article
- Characterisation of nocturnal arrhythmia avalanche dynamics: Insights from generalised linear model analysis.Journal of sleep research · 2025Article
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Authors and funding
15 authors.
Funding
Abstract
backgroundBursting nonsustained cardiac arrhythmia events are a common observation during sleep.
objectivesThe purpose of this study was to investigate the hypothesis that nocturnal arrhythmia episode durations could follow a power law, whose exponent could predict long-term clinical outcomes.
methodsWe defined "nocturnal arrhythmia avalanche" (NAA) as any instance of a drop in electrocardiographic (ECG) template-matched R-R intervals ≥30% of R-R baseline, followed by a return to 90% of baseline. We studied NAA in ECG recordings obtained from the Sleep Heart Health Study (SHHS), Osteoporotic Fractures in Men Study (MrOS) Study, and Multi-Ethnic Study of Atherosclerosis (MESA). The association of nocturnal arrhythmia durations with a power-law distribution was evaluated and the association of derived power-law exponents (α) with major adverse cardiovascular (CV) events and mortality assessed with multivariable Cox regression.
resultsA total of 9176 participants were studied. NAA episodes distribution was consistent with power-law vs comparator distributions in all datasets studied (positive log likelihood ratio of power-law vs exponential in MESA: 83%; SHHS: 69%; MrOS: 81%; power-law vs log-normal in MESA: 95%; SHHS: 35%; MrOS: 64%). The NAA power-law exponent (α) showed a significant association of with adverse CV outcomes (association with CV mortality: SHHS hazard ratio 1.39 [1.07-1.79], P = .012; MrOS hazard ratio 1.42 [1.02-1.94], P = .039; association with CV events: MESA HR 3.46 [1.46-8.21], P = .005) in multivariable Cox regression, after adjusting for conventional CV risk factors and nocturnal ectopic rate.
conclusionThe NAA power-law exponent is a reproducible, predictive marker for incident CV events and mortality.
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