循环记录器上的 asystole 在患有不明原因昏迷和负倾斜测试的患者中:年龄分布和临床预测因素
Vincenzo Russo1, Angelo Comune2, Erika Parente2
1Cardiology and Syncope Unit, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Monaldi Hospital, Naples, Italy. vincenzo.russo@unicampania.it.
大约50%的不明原因昏迷患者经历了心性暂停. 缺少前发症和β-阻断剂的使用预测了在头向上倾斜测试呈阴性结果的患者中这一发现.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
背景情况:
- 无法解释的昏迷会影响大约50%的患者.
- 在这些情况下,头向上倾斜测试 (HUTT) 通常是负的.
- 植入式循环记录仪 (ILR) 监测期间的心电图 (ECG) 文档可以揭示心痛暂停.
研究的目的:
- 为了评估由ILR检测到的辅心性昏迷的年龄分布.
- 为了确定在患有不明原因昏迷和阴性HUTT的患者中出现心性昏迷的临床预测因素.
主要方法:
- 对连续患者的回顾性,单中心研究.
- 通过ILR记录的自发性失眠,使用"不确定的病因失眠国际研究" (ISSUE) 标准进行分类.
- 考克斯多变量分析以确定独立预测因素.
主要成果:
- 在113名患者中,28名患者 (24.8%) 通过ILR被诊断出患有性失眠.
- 抑郁性昏迷显示了双模式的年龄分布:<19岁和60-79岁.
- 没有前发症的昏迷和β-阻断剂的使用独立地与ILR检测到的结相关.
结论:
- 患有不明原因昏迷和阴性HUTT的患者的非静态昏迷具有双模年龄分布.
- 这表明年轻人和老年人的潜在机制不同.
- 预发症的缺失和β-阻断剂的使用是ILR检测性心血管梗塞的关键预测因素.
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