患有心脏病和阴性电生理学测试的患者中昏睡的机制
Carlo Menozzi1, Michele Brignole, Roberto Garcia-Civera
1Department of Cardiology, Ospedale S. Maria Nuova, Reggio Emilia, Italy.
Circulation
|June 12, 2002
概括
患有结构性心脏病和不明原因昏迷的患者有良好的预后. 植入式循环记录器揭示了多种原因,心室动脉节律失常不太可能.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 内部医学 内部医学
背景情况:
- 结构性心脏病患者的昏迷通常被认为源于心律失常.
- 确切的机制尚不清楚,特别是当初始的电生理学研究产生不显著的结果时.
研究的目的:
- 研究结构性心脏病患者昏睡的机制和结果,以及负面的电生理学研究.
- 评估植入式循环记录器在高风险人群中诊断昏的实用性.
主要方法:
- 植入式循环记录器被用于35名患有结构性心脏病和昏迷病史的患者.
- 患者有心室心律不整的危险因素,包括先前的心肌梗塞,减少喷射率或非持续的心室心律不整.
- 随访时间为3至15个月.
主要成果:
- 昏迷在6名患者 (17%) 中复发,其中的机制包括胸心梗塞 (AV阻塞,鼻停止),鼻高心率和慢性心房动中心室频率增加.
- 昏迷前期 (23%) 涉及各种节律变化,包括心房动/心跳动以及持续的腹腔心跳动的一例.
- 在研究期间,没有死亡或昏迷相关的伤害发生.
结论:
- 患有不明原因昏迷,结构性心脏病和负电生理学研究的患者显示中期结果有利.
- 在这个队列中昏睡的潜在机制是多样化的,而主心室动脉节律失常是不常见的原因.
- 植入式循环记录器对于诊断结构性心脏病患者的昏迷非常有价值.
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