心内电图T波交替/变异性增加在可植入心脏转换器-除器患者的自发性腹腔动脉节律失常之前:一个前性的多中心研究
Charles Swerdlow1, Theodore Chow, Mithilesh Das
1Cedars-Sinai Medical Towers, 8635 W Third St, Ste 1190-W, Los Angeles, CA 90048. swerdlow@ucla.edu.
Circulation
|March 2, 2011
概括
从植入式心脏转换器-除器电图测量T波交替 (TWA/V) 在心室动脉冲动/心 (VT/VF) 事件发生之前显著更高. 这一发现表明,TWA/V可以作为即将到来的VT/VF的关键警告信号.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
背景情况:
- 图波替代体 (TWA) 是已知的心室动脉冲动 (VT) 和心肌 (VF) 的前体.
- 一种新的方法测量了TWA和nonalternans变异性 (TWA/V) 来自可植入心脏转换器-除器 (ICD) 电图 (EGM).
研究的目的:
- 为了前性地评估EGM TWA/V是否在ICD患者的VT/VF发作之前升高,与基线相比.
- 评估 EGM TWA/V 对 VT/VF 事件的预测价值.
主要方法:
- 一项前性多中心研究,涉及63名ICD患者.
- 在自发VT/VF和各种对照记录 (基线,节奏,霍尔特,SVT) 之前,从存储的EGM计算TWA/V.
- 后勤回归用于确定TWA/V和VT/VF赔率之间的关联.
主要成果:
- 在随访期间,28名患者共发生了166次VT/VF发作.
- 在VT/VF前,EGM TWA/V显著大于所有对照条件 (62.9±3.1μV) (P < 0.0001).
- 每增加10μV的TWA/V与VT/VF几率增加2.2倍相关 (P < 0.0001).
结论:
- 在ICD患者中,EGM TWA/V是先于自发性VT/VF的强有力的指标.
- 在未来的ICD中,对EGM TWA/V的持续监测可以为VT/VF提供早期警告和预防性节奏疗法.
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