Heart rate turbulence
Heart rate turbulence
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DOI：
10.1016/j.jelectrocard.2003.09.020
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发表时间：
2003-01-01
影响因子：
1.3
通讯作者：
Schmidt, G
中科院分区：
文献类型：
--
作者：
Bauer, A;Schmidt, G
急性心肌梗塞的幸存者心源性猝死的风险增加。最近的试验表明，在选定的心肌梗死后高危患者中，植入自主神经性心律转复除颤器可以显着降低死亡率。因此，风险分层策略变得越来越重要。最近，一种新的风险分层方法--被称为心率湍流--已经发表。该方法量化了单发室性早搏后窦性心律周期长度的生理性短期波动。心率震荡是低风险缺血性心脏病患者的一贯现象。没有这一现象表明随后死亡的风险显著增加。量化心率震荡、震荡起始和震荡斜率的指标是强有力的风险预测指标，即使调整了其他已建立的死亡率预测指标，如左室射血分数、心律失常计数、心率变异性、平均心率和既往心肌梗死病史。心率震荡不仅可用于心肌梗死后患者的风险预测，也可用于其他患者的风险预测，如扩张型心肌病和恰加斯病患者。
Survivors of acute myocardial infarction are at increased risk of sudden cardiac death. Recent trials have demonstrated that in selected high risk post-myocardial infarction patients mortality can be significantly reduced by implantation of an autonomic cardioverter defibrillator. Therefore, risk stratification strategies have gained increasing importance. Recently, a new method for risk stratification, coined heart rate turbulence, has been published. The method quantifies the physiological short term fluctuation of sinus rhythm cycle lengths following singular ventricular premature complexes. Heart rate turbulence is a consistent phenomenon in low risk patients with ischemic heart disease. The absence of this phenomenon indicates a significantly increased risk of subsequent mortality. The measures for quantifying heart rate turbulence, turbulence onset, and turbulence slope are strong risk predictors, even when adjusted for other established mortality predictors, such as left ventricular ejection fraction, arrhythmia count, heart rate variability, mean heart rate and history of previous myocardial infarction. Heart rate turbulence may be useful not only for risk prediction in post-myocardial infarction patients but also for risk prediction in other patients such as in patients with dilated cardiomyopathy and Chagas disease.