Skin sympathetic nerve activity and the temporal clustering of cardiac arrhythmias
Skin sympathetic nerve activity and the temporal clustering of cardiac arrhythmias
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DOI：
10.1172/jci.insight.125853
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发表时间：
2019-02-21
期刊：
影响因子：
8
通讯作者：
Chen, Peng-Sheng
中科院分区：
文献类型：
--
作者：
Kusayama, Takashi;Wan, Juyi;Chen, Peng-Sheng
背景同时无创记录的皮肤交感神经活动（SKNA）和心电图（neuECG）可用于估计心脏交感神经张力。我们测试的假设，即大的和长期的SKNA爆发与时间聚类mammias.METHODS。我们记录了10例房颤（AF）发作患者（69 ± 10岁）和6例室性心动过速（VT）或房颤（VF）发作患者（50 ± 13岁）的neuECG。丛集性心律失常的定义为：在1分钟内发生心律失常发作，随后发生相同心律失常的自发复发。在500 - 1000 Hz之间对neuECG信号进行带通滤波，以显示SKNA.有22个AF簇，包括6例患者的231次AF发作，9个VT/VF簇，包括3例患者的99次VT/VF发作。与AF相关的SKNA爆发的总持续时间长于窦性心律期间的持续时间（78.9 min/h [四分位距（IQR）17.5 - 201.3] vs. 16.3 min/h [IQR 14.5 - 18.5]，P = 0.022）。聚集性房颤患者与房颤相关的爆发振幅显著高于非聚集性房颤患者（1.54 μ V [IQR 1.35 - 1.89]，n = 114，vs. 1.20 μ V [IQR 1.05 - 1.42]，n = 21，P <0.001）。与VT/VF簇相关的SKNA爆发持续9.3 +/-3.1分钟，峰值平均为1.13 +/-0.38 μ V，而基线时为0.79 +/-0.11 μ V（P = 0.041）。大的和持续的交感神经活动与AF和VT/VF的时间聚集有关。
BACKGROUND. Simultaneous noninvasively recorded skin sympathetic nerve activity (SKNA) and electrocardiogram (neuECG) can be used to estimate cardiac sympathetic tone. We tested the hypothesis that large and prolonged SKNA bursts are associated with temporal clustering arrhythmias.METHODS. We recorded neuECG in 10 patients (69 +/- 10 years old) with atrial fibrillation (AF) episodes and in 6 patients (50 +/- 13 years old) with ventricular tachycardia (VT) or fibrillation (VF) episodes. Clustering was defined by an arrhythmic episode followed within 1 minute by spontaneous recurrences of the same arrhythmia. The neuECG signals were bandpass filtered between 500-1000 Hz to display SKNA.RESULTS. There were 22 AF clusters, including 231 AF episodes from 6 patients, and 9 VT/VF clusters, including 99 VT/VF episodes from 3 patients. A total duration of SKNA bursts associated with AF was longer than that during sinus rhythm (78.9 min/hour [interquartile range (IQR) 17.5-201.3] vs. 16.3 min/hour [IQR 14.5-18.5], P = 0.022). The burst amplitude associated with AF in clustering patients was significantly higher than that in nonclustering patients (1.54 mu V [IQR 1.35-1.89], n = 114, vs. 1.20 mu V [IQR 1.05-1.42], n = 21, P < 0.001). The SKNA bursts associated with VT/VF clusters lasted 9.3 +/- 3.1 minutes, with peaks that averaged 1.13 +/- 0.38 mu V as compared with 0.79 +/- 0.11 mu V at baseline (P = 0.041).CONCLUSION. Large and sustained sympathetic nerve activities are associated with the temporal clustering of AF and VT/VF.