在慢性抗心律失常治疗期间,心室外宫外活动的自发变化
J L Anderson1, M I Anastasiou-Nana, R L Menlove
1Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City.
Circulation
|September 1, 1990
概括
即使在有效的抗失常药物治疗中,心室失常频率的变化也是显著的. 由于广泛的自发变异性,单个霍尔特测试可能不会准确地反映治疗的有效性.
科学领域:
- 心脏病学 心脏病学
- 临床电生理学 临床电生理学
背景情况:
- 之前关于心室失常变性的研究依赖于没有治疗的记录.
- 在有效的抗失常药物治疗期间评估变异性对于准确的评估至关重要.
研究的目的:
- 评估在有效的抗心律失常药物治疗期间早产腹腔复合物 (PVCs) 抑制的变化.
- 为了确定治疗期间PVC频率自发变化的置信限值.
主要方法:
- 分析了55名患有慢性心律失常的患者的门诊心电图记录,这些患者正在接受有效的抗心律失常疗法.
- 定义有效疗法为:总PVC减少≥70%或重复形式减少≥90%.
- 基于年龄,性别,病因,心脏功能和药物治疗的患者子组中抑制的检查变异性.
主要成果:
- 观察到PVC抑制的显著变化,随着时间的推移,有效性大幅下降.
- 19%的患者在总PVC的抑制率下降到60%以下,16%的患者在PVC频率上升到基线以上.
- 在具有较高PVC频率,β阻断剂使用和非冠状动脉疾病的子组中,变异性更大,但在老年患者和心脏功能较差的患者中,临床抑制损失更为常见.
结论:
- 在有效的抗心律失常疗法期间,心律失常频率发生了显著的变化.
- 对于自发变异性的95%信任限需要对单个霍尔特测试进行仔细的解释.
- 节律失常频率的变化应谨慎地归因于治疗失败,特别是在特定的患者亚组.
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