Reliability of serial 24 h ambulatory electrocardiography in predicting cardiac death after myocardial infarction.
Reliability of serial 24 h ambulatory electrocardiography in predicting cardiac death after myocardial infarction.
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连续 24 小时动态心电图预测心肌梗死后心源性死亡的可靠性。
DOI：
10.1093/oxfordjournals.eurheartj.a061263
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发表时间：
1982
影响因子：
39.3
通讯作者：
M. Møller
中科院分区：
文献类型：
--
作者：
M. Møller
连续100例年龄在70岁以下的急性心肌梗死患者，在住院后期以及梗死后1个月、3个月和6个月接受24小时心电图监测。复杂的室性心律失常（多种形式，对联，R对T，室性心动过速）被发现在34，51，41和39%的患者在四个场合，分别。出院后，患者出院率显著提高（34%对51%，P <0.05）。复杂性心律失常患者的累积百分比分别为34、65、74和79%，表明个体内差异很大。在所有监测中，仅6例患者出现复杂室性心律失常。定量和定性心律失常模式之间的密切相关性被证明。在平均30个月（范围27-34）的随访期内发生了19例心脏性死亡。在住院后期，而不是之后，复杂的室性心律失常在随后发生心源性死亡的患者中明显更常见（P <0.05）。在11例心源性死亡的患者中，他们的最终监测没有复杂的室性心律失常。由于这些心律失常在大多数患者中得到证实，并且在个体患者中不时显示出相当大的变化，因此即使是连续24小时动态心电图在识别心肌梗死后明确的高或低风险组方面也存在严重局限性。
One hundred consecutive patients below the age of 70 years, surviving an acute myocardial infarction, were subjected to 24-h electrocardiographic monitoring during the late hospital phase, as well as at one, three and six months after the infarction. Complex ventricular arrhythmias (multiform, couplets, R on T, ventricular tachycardia) were found in 34, 51, 41 and 39% of the patients on the four occasions, respectively. Thus a significant increase was found in relation to discharge (34 v. 51%, P <0.05). The cumulative percentage of patients with complex arrhythmias was 34, 65, 74 and 79% respectively, indicating a considerable intra-individual variation from time to time. Complex ventricular arrhythmias were found in only six patients during all monitorings. A close correlation between the quantitative and qualitative arrhythmia pattern was demonstrated. Nineteen cases of cardiac death occurred during an average follow-up period of 30 (range 27–34) months. During the late hospital phase, but not afterwards, complex ventricular arrhythmias were significantly more frequent in patients who subsequently had cardiac death (P <0.05). In 11 patients who had cardiac death, their final monitoring was without complex ventricular arrhythmias. As these arrhythmias were demonstrated in the large majority of patients and showed a considerable variation from time to time in the individual patient, even serial 24 h ambulatory electrocardiography has severe limitations in identifying well-defined high or low risk groups after myocardial infarction.