The electrical properties of the mammalian heart undergo many complex transitions in normal and diseased states1,2,3,4,5,6,7. It has been proposed that the normal heartbeat may display complex nonlinear dynamics, including deterministic chaos8,9, and that such cardiac chaos may be a useful physiological marker for the diagnosis10,11,12 and management13,14 of certain heart trouble. However, it is not clear whether the heartbeat series of healthy and diseased hearts are chaotic or stochastic15,16,17, or whether cardiac chaos represents normal or abnormal behaviour18. Here we have used a highly sensitive technique, which is robust to random noise, to detect chaos19. We analysed the electrocardiograms from a group of healthy subjects and those with severe congestive heart failure (CHF), a clinical condition associated with a high risk of sudden death. The short-term variations of beat-to-beat interval exhibited strongly and consistently chaotic behaviour in all healthy subjects, but were frequently interrupted by periods of seemingly non-chaotic fluctuations in patients with CHF. Chaotic dynamics in the CHF data, even when discernible, exhibited a high degree of random variability over time, suggesting a weaker form of chaos. These findings suggest that cardiac chaos is prevalent in healthy heart, and a decrease in such chaos may be indicative of CHF.
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Smith, J. M. & Cohen, R. J. Simple finite-element model accounts for wide range of cardiac dysrhythmias. Proc. Natl Acad. Sci. USA 81, 233–237 (1984).
Chialvo, D. R. & Jalife, J. Nonlinear dynamics of cardiac excitation and impulse propagation. Nature 330, 749–752 (1987).
Chialvo, D. R., Gilmour, R. F. & Jalife, J. Low-dimensional chaos in cardiac tissue. Nature 343, 653–657 (1990).
Jalife, J. Ann. NY Acad. Sci. 591((1990)).
Davidenko, J. M., Pertsov, R. S., Baxter, W. & Jalife, J. Stationary and drifting spiral waves of excitation in isolated cardiac muscle. Nature 355, 349–351 (1989).
Winfree, A. T. Electrical turbulence in three-dimensional heart muscle. Science 266, 1003–1006 (1994).
Glass, L. Dynamics of cardiac arrhythmias. Phys. Today 40–45 (1996).
Goldberger, A. L. Is the normal heartbeat chaotic or homeostatic? News Physiol. Sci. 6, 87–91 (1991).
Sugihara, G., Allan, W., Sobel, D. & Allan, K. D. Nonlinear control of heart rate variability in human infants. Proc. Natl Acad. Sci. USA 93, 2608–2613 (1996).
Denton, T. A., Diamond, G. A., Helfant, R. H., Khan, S. & Karagueuzian, H. Fascinating rhythm: A primer on chaos theory and its application to cardiology. Am. Heart J. 120, 1419–1440 (1990).
Skinner, J. E., Goldberger, A. L., Mayer-Kress, G. & Ideker, R. E. Chaos in the heart: Implications for clinical cardiology. Biotechnology 8, 1018–1024 (1990).
Goldberger, A. L. Nonlinear dynamics for clinicians: Chaos theory, fractals and complexity at the bedside. Lancet 347, 1312–1314 (1996).
Garfinkel, A., Spano, M. L., Ditto, W. L. & Weiss, J. N. Controlling cardiac chaos. Science 257, 1230–1235 (1992).
Garfinkel, A., Weiss, J. N., Ditto, W. L. & Spano, M. L. Chaos cotnrol of cardiac arrhythmias. Trends Cardiovasc. Med. 5, 76–80 (1995).
Kaplan, D. T. & Cohen, R. J. Is fibrillation chaos? Circ. Res. 67, 886–892 (1990).
Kanters, J. K., Holstein-Rathlou, N.-H. & Agner, E. Lack of evidence for low-dimensional chaos in heart rate variability. J. Cardiovasc. Electrophysiol. 5, 591–601 (1994).
Turcott, R. G. & Teich, M. C. Fractal character of the electrocardiogram: Distinguishing heart-failure and normal patients. Ann. Biomed. Eng. 24, 269–293 (1996).
Glass, L. Is cardiac chaos normal or abnormal? J. Cardiovasc. Electrophysiol. 1, 481–482 (1990).
Barahona, M. & Poon, C.-S. Detection of nonlinear dynamics in short, noisy time series. Nature 381, 215–217 (1996).
Peng, C. K., Havlin, S., Stanley, H. E. & Goldberger, A. L. Quantification of scaling exponents and crossover phenomena in nonstationary heartbeat time series. Chaos 5, 82–87 (1995).
Ivanov, P. C. et al. Scaling behaviour of heartbeat intervals obtained by wavelet-based time-series analysis. Nature 383, 323–327 (1996).
Goldberger, A. L., Rigney, D. R., Mietus, J., Antman, E. W. & Greenwald, S. Nonlinear dynamics in sudden cardiac death syndrome: heartrate oscillations and bifurcations. Experientia 44, 983–987 (1988).
Casolo, G., Balli, E., Taddei, T., Amuhasi, J. & Gori, C. Decreased spontaneous heart rate variability on congestive heart failure. Am. J. Cardiol. 64, 1162–1167 (1989).
Grebogi, C., Ott, E., Pelikan, S. & Yorke, J. A. Strange attractors that are not chaotic. Physica D 13, 261–268 (1984).
Pomeau, Y. & Manneville, P. Intermittent transition to turbulence in dissipative dynamical systems. Commun. Math. Phys. 74, 189–197 (1980).
Skinner, J. E., Pratt, C.-M. & Vybiral, T. A. Reduction in the correlation dimension of heartbeat intervals precedes imminent ventricular fibrillation in human subjects. Am. Heart J. 125, 731–743 (1993).
We thank A. L. Goldberger and R. G. Mark for discussions and comments on the manuscript, and A. L. Goldberger and J. E. Mietus for providing the heartbeat data. This work was supported by grants from the National Heart, Lung and Blood Institute, National Science Foundation, and Office of Naval Research.
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Poon, C., Merrill, C. Decrease of cardiac chaos in congestive heart failure. Nature 389, 492–495 (1997). https://doi.org/10.1038/39043
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