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This manuscript attempts to link the physiological uses of measuring short term heart rate variations with the finding that quantification of long term heart rate variability is predictive of sudden death after myocardial infarction. The mechanisms which underlie short term variations of heart rate and the data which have provided the association between long term variations of heart rate and sudden death are reviewed. An argument is then made to support the hypothesis that changes in long term heart rate variability may be driven more by activity level and the heart’s response to that activity than by abnormalities of sympathetic and parasympathetic heart rate control.
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