摘要
目的 通过比较心室程序刺激致诱发性窦性心率震荡和室性早搏后自发性窦性心率震荡参数测定,观察不同部位室性早搏刺激对窦性心率震荡的影响,进而评价动态心电图心率震荡参数的可信度.方法 20例阵发性室上性心动过速（PSVT）患者,分别选取右室心尖部（RVAP）和右室流出道（RVOT）作为早搏的刺激部位,分别通过Holter行自发性HRT检测和心室程序刺激行诱发性HRT检测,比较心室不同部位刺激所诱发的窦性心率震荡参数——震荡初始（TO）和震荡斜率（TS）的差异.结果 诱发性窦性心率震荡和自发性窦性心率震荡测定结果无显著差异[TO：（-1.71±1.36）％比（-2.29±1.47）％,P=0.12;TS：（7.12±4.68）ms/RR比（10.14±5.71）ms/RR,P=0.75].心室不同刺激部位对诱发性窦性心率震荡结果无明显影响[TO：（-7.16±1.74）％比（-8.82±2.16）％,P=0.14;TS：（20.9±4.38）ms/RR比（18.8±3.67）ms/RR,P=0.36].不同部位诱发的心率震荡参数TO和TS自身之间亦有较好的相关性（TO：r=0.674,P＜0.01;TS：r=0.816,P＜0.01）.结论 诱发性窦性心率震荡与自发性窦性心率震荡具有一致性,心室不同刺激部位对诱发性窦性心率震荡结果无明显影响,动态心电图记录中,由心室不同部位的室性早搏所计算的心率震荡参数值均有较高的可信度.
Objective To compare the parameters of induced HRT after programmed ventricular stimuli and spontaneous HRT after ventricular premature and to survey the influence and the correlation of the point of origin on heart rate turbulence after stimulated ventricular premature beats, furthermore, to investigate the reliability of the HRT parameter derived from Holter ECGs. Methods Spontaneous HRT derived from extra ventricular beats extracted from Holter ECG and induced HRT from extra ventricular beats extracted from programmed ventricular stimuli were studied and the TO and TS were compared for 20 electrophysiology patients of paroxysmal supraventricular tachycardia （PSVT）. During the electrophysiologic study, premature extra beats were induced in right ventricular apex（RVAP） and right ventricular outflow tract（RVOT） representing the ventricular pacing sites. Results Inducible and Spontaneous HRT were indistinguishable according to turbulence onset [（-1.71±1.36）% vs （-2.29±1.47）%, P=0.12], turbulence slope[（7.12±4.68）ms/RR vs （10.14±5.71）ms/RR, P=0.75]. There were no sig- nificant effects on different pacing site of origin [TO： （-7.16±1.74）% vs （-8.82±2.16）%, P=0.14; TS： （20.9±4.38）ms/RR vs （18.8±3.67）ms/RR, P=0.36]. Also correlated with themselves （TO：r=0.674,P=0.01; TS：r= 0.816, P〈0.01 ）. Conclusion Heart rate turbulence induced in the electrophysiology laboratory were similar to those following spontaneous PVCs and induced turbulence was a valid model for study under controlled conditions. The site of origin of the ventricular premature beat exhibits no influence on heart rate turbulence onset and slope. Therefore, the calculation of heart rate turbulence derived from extra ventrieular beats extracted from Holter ECG is reliable.
出处
《中国心血管病研究》
CAS
2014年第11期1001-1004,共4页
Chinese Journal of Cardiovascular Research
关键词
室性早搏
窦性心率震荡
心室程序刺激
自发性
诱发
Ventricular premature beat
Heart rate turbulence
Programmed ventricular stimuli
Spontaneous
Induced
