心臓病と陰性電気生理学検査の患者におけるのメカニズム
Carlo Menozzi1, Michele Brignole, Roberto Garcia-Civera
1Department of Cardiology, Ospedale S. Maria Nuova, Reggio Emilia, Italy.
Circulation
|June 12, 2002
まとめ
構造的な心臓病と原因不明の昏睡を患っている患者は,予後が良好です. 埋め込み式ループレコーダーは様々な原因を明らかにし,心室性タキアリズムが起こりそうにない.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 内科内科は,内科の内科である.
背景:
- 構造的な心臓病の患者の昏睡は,しばしば心律不良から生じるものと推定されます.
- 正確なメカニズムは不明であり,特に最初の電気生理学的研究が非顕著な結果をもたらす場合,特に不明です.
研究 の 目的:
- 構造的な心臓病の患者における昏睡のメカニズムと結果を調査し,陰性電気生理学的研究を行う.
- この高リスク集団におけるシンコペの診断における,埋め込み式ループレコーダーの有用性を評価する.
主な方法:
- 埋め込み式ループレコーダーは,構造的な心臓病と失眠歴のある35人の患者に使用されました.
- 患者は,前回の心筋梗塞,エジェクション分数の減少,または持続しない心拍不全などの心室不律のリスク要因を持っていた.
- フォローアップ期間は3ヶ月から15ヶ月でした.
主要な成果:
- 昏睡は6人の患者 (17%) に再発し,そのメカニズムにはブラジカルディア (AVブロック,シナウス停止),シナウス短心,および慢性心房動における心房率の増加が含まれています.
- プレシンコプのエピソード (23%) は,心房細動/心拍不全および持続した心拍不全の1例を含む様々なリズム変異を伴う.
- 研究期間中,死亡や昏睡に関連した怪我は発生しませんでした.
結論:
- 原因不明の昏睡,構造的な心臓病,そして否定的な電気生理学的研究を持つ患者は,中期的に好ましい結果を示しています.
- このコホートにおける昏睡の根本的なメカニズムは多様で,主心室性タキアリズム症は稀な原因である.
- 埋め込み式ループレコーダーは,構造的な心臓病の患者の昏睡の診断に価値があります.
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