In patients following a myocardial infarction, heart rate variability is an important prognostic factor. Decreased heart rate variability is associated with a higher mortality rate. This study evaluated the influence of recanalisation by percutaneous coronary intervention (PCI) in totally occluded coronary arteries on the heart rate variability in patients with myocardial akinesis in the recanalised artery area. The study group included 22 men (average age 52.8 +/- 7.7) after successful PCI recanalization of the totally occluded artery. All patients had akinesis in the recanalised artery area. All patients underwent 24-hour continuous electrocardiographic Holter monitoring with HRV analysis and echocardiographic dobutamine tests both before the PCI and 6 months afterwards. The population was divided into two groups: group A (10 patients) had contractility adjustments in echocardiographic tests that were performed 6 months after the PCI. Group B (12 patients) did not have contractility adjustments. Before the PCI, there were no differences in the wall motion score index (WMI) or the time-domain HRV parameters between the two groups. After 6 months, there was a significant increase in the WMI value in group A, whereas this index remained unchanged in group B. In group A the time-domain HRV parameters had improved 6 months after the PCI, whereas they remained unchanged in group B. Successful percutaneous revascularization of the totally occluded coronary artery in patients with myocardial akinesis in the occluded artery area leads to an increase in HRV parameters. This improvement occurred only in patients that had a contractility adjustment after the PCI in previous akinetic segments of myocardium.