微电压T波交替子作为心室动脉节律失常的预测因素:使用心房节奏的前性研究
Kaoru Tanno1, Syunsho Ryu, Norikazu Watanabe
1Third Department of Internal Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan. k-tanno@p02.itscom.ne
Circulation
|April 7, 2004
概括
患有心率较低的微伏特T波交替 (TWA) 患者患心室动脉节律失常的风险增加. 这一发现强调了心率在评估TWA突然心脏死亡风险时的重要性.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心律不整的研究研究心律不整.
背景情况:
- 微电压T波替代体 (TWA) 是心脏突然死亡 (SCD) 和心室低心率 (VT) 的公认标志物.
- 以前的研究表明,TWA表现和心率之间存在显著的相关性.
- 心率对TWA对心室动脉节律失常的预测值的影响需要进一步研究.
研究的目的:
- 研究心率较低时检测到的TWA与心室动脉节律失常症的风险之间的关系.
- 为了确定在心率降低时表现出TWA的患者是否更容易患有危及生命的心律失常.
主要方法:
- 在1997年至2000年期间,对248名患者进行了电生理学研究.
- 在鼻腔节律和心房节拍期间,TWA以每分钟90,100,110和120次的速度记录.
- 测量了替代电压 (V(alt)) ,并对患者进行了VT,VF,SCD或适当的植入式心脏转换器-除器治疗的跟踪.
主要成果:
- 在VT/VF/SCD发病率较高的患者中,V{alt}>1.9微V在90,100和110bpm时 (分别为56%,28%,18%) 观察到较高的VT/VF/SCD发病率.
- 在90bpm时的>2.9微V的V{\alt}显示了70%的VT/VF/SCD的积极预测值.
- 120bpm时的微伏<0.9显示出100%的负预测值,这表明心率更高时的安全性.
结论:
- 检测到心率相对较低的TWA患者表现出对心室动脉节律不良的敏感性增加.
- 心率是TWA解释突然心脏死亡风险分层的关键因素.
- 这些发现强调了在评估TWA对心律失常风险时考虑心率的重要性.
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