Heart rate variability patterns before ventricular tachycardia onset in patients with as implantable cardioverter defibrillator
Heart rate variability patterns before ventricular tachycardia onset in patients with as implantable cardioverter defibrillator
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DOI：
10.1016/s0002-9149(00)01130-9
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发表时间：
2000-11-01
影响因子：
2.8
通讯作者：
De Rosa, A
中科院分区：
文献类型：
--
作者：
Lombardi, F;Porta, A;De Rosa, A
心率变异性（HRV）的时域和频域分析已被证明在描述自主控制机制的改变和识别心脏和心脏病死亡率增加的患者方面是有效的。植入心律转复除颤器的患者提供了在室性心动过速（VT）之前和在控制条件下评估HRV模式的机会。因此，我们分析了短期HRV的时域和频域参数以及静息时、15 - 30分钟时和VT前RR间期时间序列的幂律行为。与对照条件相比，VT前观察到平均循环长度持续时间和总功率值较低。频谱分析表明，VT前即刻的低频与高频比值（5.5 +/- 0.6 vs 2.8 +/- 0.3）显著高于静息时，这两项发现与交感迷走神经平衡向交感优势和迷走神经张力降低的方向转移一致。在VT之前，功率-频率关系的标度指数β的更负值（-1.57 +/- 0.04 vs -1.33 +/- 0.04）也证实了与对照组相比存在改变的HRV模式。因此，心率变异性的异常自主调节和动态模式似乎是这些患者心律失常发作前几分钟的特征，（C）2000年由Excerpta Medico，Inc.
Time- and frequency-domain analysis of heart rate variability (HRV) has been proven effective in describing alteration of autonomic control mechanisms and in identifying patients with increased cardiac and arrhythmic mortality. Patients with implantable cardioverter defibrillators offer the opportunity to evaluate HRV patterns before ventricular tachycardia (VT) and under control conditions. We therefore analyzed time- and frequency-domain parameters of short-term HRV and power-law behavior of RR interval time series at rest, at 15 to 30 minutes, and immediately before VT. In comparison to control conditions, lower values of mean cycle length duration and total power were observed before VT. Spectral analysis indicated that the low- to high-frequency ratio was significantly higher (5.5 +/- 0.6 vs 2.8 +/- 0.3) immediately before VT than during rest, Both findings were consistent with the shift of sympathovagal balance toward sympathetic predominance and reduced vagal tone. Before VT, a more negative value of the scaling exponent beta of the power-frequency relation (-1.57 +/- 0.04 vs -1.33 +/- 0.04) also confirmed the presence of an altered HRV pattern in comparison to controls. Thus, both abnormal autonomic modulation and dynamic patterns of HRV seem to characterize the minutes before arrhythmia onset in these patients, (C)2000 by Excerpta Medico, Inc.