Abstract: Objective To investigate the predictive value of the non-invasive indicator deceleration capacity of heart rate (DC) in the sudden cardiac death (SCD) after acute myocardial infarction. Methods A total of 417 myocardial infarc⁃ tion patients with ST-segment elevation in sinus rhythm were enrolled in this study. DC was assessed from data of 24-hour ECG Holter. Regular follow-ups were carried out within 12 months. The SCD events were recorded and compared with patients without SCD. Results During 12 months of follow-up, 20 patients were died due to SCD (4.8%). Compared with sur⁃ vival group, patients showed significantly lower left ventricular ejection fraction (LVEF, 0.393 ± 0.065 vs 0.528 ± 0.042, P＜0.05) and DC [(2.85±1.66) ms vs (5.49±1.71) ms， P＜0.05]in SCD group. Multivariate Cox proportional hazard regression analysis showed that lower LVEF(＜0.35)［RR: 2.167(1.384- 4.661), P=0.013］and DC (DC＜4.5 ms)［RR: 3.706(2.709- 5.374)， P=0.020］ were risk factors for the occurrence of SCD. The prediction sensitivity by the decreased LVEF and DC was 52.1% and 76.4% respectively, and the specificity was 84.5% and 86.1% respectively. Conclusion The decreased value of DC after acute myocardial infarction can predict the SCD events.

Key words: myocardial infarction, death, sudden, cardiac, left ventricular ejection fraction, deceleration capacity of rate