每日变化和最佳时间来测量基于霍尔特的晚期潜力,以预测心肌梗塞后致命性心律失常
Kenichi Hashimoto1, Naomi Harada1, Motohiro Kimata1
1Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan.
基于霍尔特的晚期潜力 (LP) 测试的最佳时间对于预测致命心律失常至关重要. 当低振幅信号 (LAS40) 最糟糕时测量LP,通常是在晚上,可以提高识别患有突然心脏死亡风险的患者的准确性.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 基于霍尔特的晚期潜力 (LPs) 是已确定的有机心脏病中致命心律失常的预测因素.
- 已知LP的日间变化,但预测突发心脏病死亡的最佳测量时间仍未得到研究.
研究的目的:
- 为了验证基于霍尔特的LP测试最有效的时间.
- 探索影响LP参数日间变化的因素,以改善心律失常的预测.
主要方法:
- 对126名心肌梗塞 (MI) 后患者和60名接受高分辨率霍尔特心电图的对照进行了回顾性分析.
- 包括LAS40在内的LP参数在24小时内6次间隔测量.
- 进行了心率变化分析,以确定影响因素.
主要成果:
- LP参数表现出白天变化,晚上恶化,白天改善.
- 测量LAS40在低振幅信号 (<40μV) 的最长持续时间时,为静脉瘤预测提供了最高的准确性 (AUC 0.659).
- 心率和噪音显著影响了LP参数;在非静脉训练组中,副交感活动影响了LP.
结论:
- 基于霍尔特的LP测试的准确性在LAS40值最差的时期测量时最大化,通常是在晚上.
- 自主神经系统活动,特别是心率和副交感音调,影响LP的日间变化.
- 增加的副交感活动或胸可能会加剧基于霍尔特的LP参数,影响心律失常风险评估.
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