Feasibility of multiple short, 40-s, intra-procedural ECG recordings to detect immediate changes in heart rate variability during catheter ablation for arrhythmias.
Feasibility of multiple short, 40-s, intra-procedural ECG recordings to detect immediate changes in heart rate variability during catheter ablation for arrhythmias.
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DOI：
10.1007/s10840-011-9580-2
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发表时间：
2011-11
影响因子：
1.8
通讯作者：
Kanagaratnam, Prapa
中科院分区：
文献类型：
--
作者：
Lim, Phang Boon;Malcolme-Lawes, Louisa C.;Stuber, Thomas;Koa-Wing, Michael;Wright, Ian J.;Tillin, Therese;Sutton, Richard;Davies, D. Wyn;Peters, Nicholas S.;Francis, Darrel P.;Kanagaratnam, Prapa
本研究旨在评价一种在心律失常消融术期间使用短ECG段检测心率变异性（HRV）变化的方法。从连续较短的时间窗口，从5分钟的心电图记录在15名健康志愿者的平均心率变异性。40-s窗口被确定为在高频（HF）和低频（LF）HRV中产生可重复值的最短持续时间。该方法在接受倾斜试验的患者中得到验证，以观察是否可以从多个40秒记录中检测到晕厥前发生的HRV预期调制。最后，该方法用于评估75例因房颤（AF）和其他心律失常接受消融术的患者的HRV变化，以观察是否可以检测到消融术导致的自主调节。另外14例患者在房颤消融术的不同阶段进行了逐步HRV测量，以确定是否可以检测到术中HRV变化。心率变异性，从多个40秒记录中平均，显示晕厥前即刻与基线相比预期增加（LF：341 ± 311- 1，536 ± 1，368 ms 2，p < 0.05; HF：342 ± 339- 1，628 ± 1，755 ms 2，p < 0.05）。房颤消融，特别是右肺静脉环周消融后，可立即检测到LF（153 ± 251-50 ± 116 ms 2，p < 0.001）和HF（86 ± 195-33 ± 83 ms 2，p < 0.001）的降低，而RR间期（877 ± 191-843 ± 220 ms，p = 0.261）无任何变化。心房扑动消融术未改变平均RR间期、LF或HF HRV。对多个40秒窗口求平均值可提供有效的HF和LF HRV测量值，从而能够检测术中变化。右肺静脉周围的左心房消融术在降低HRV方面是独一无二的。该方法有可能用作辅助自主消融手术的终点标记。
This study aims to evaluate a method to detect heart rate variability (HRV) changes using short ECG segments during ablation for arrhythmias. HRV was averaged from sequentially shorter time windows from 5-min ECG recordings in 15 healthy volunteers. The 40-s window was identified as the shortest duration that yielded reproducible values in high frequency (HF) and low frequency (LF) HRV. This method was validated in patients undergoing tilt table testing to see if the expected modulation in HRV that occurs prior to syncope could be detected from multiple 40-s recordings. Lastly, this method was used to assess HRV changes in 75 patients undergoing ablation for atrial fibrillation (AF) and other arrhythmias, to see if autonomic modulation as a result of ablation could be detected. A further 14 patients had stepwise HRV measurements at different stages of the AF ablation procedure to determine whether intra-procedural HRV changes could be detected. HRV, averaged from multiple 40-s recordings, demonstrated the expected increase immediately preceding syncope compared with baseline (LF: 341 ± 311–1,536 ± 1,368 ms2, p < 0.05; HF: 342 ± 339–1,628 ± 1,755 ms2, p < 0.05). AF ablation, particularly following right pulmonary vein circumferential ablation, produced immediately detectable reductions in LF (153 ± 251–50 + 116 ms2, p < 0.001) and HF (86 ± 195–33 ± 83 ms2, p < 0.001) without any change in RR interval (877 ± 191–843 ± 220 ms, p = 0.261). Ablation for atrial flutter did not change the mean RR interval, LF or HF HRV. Averaging multiple 40-s windows give valid HF and LF HRV measurements that enable detection of intra-procedural changes. Left atrial ablation around the right-sided pulmonary veins is unique in producing reductions in HRV. This method has the potential for use as an endpoint marker for adjunctive autonomic ablation procedures.
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影响因子：
6
作者：
Davies, LC;Francis, DP;Coats, AJS
通讯作者：
Coats, AJS
影响因子：
--
作者：
ARDELL, JL;RANDALL, WC
通讯作者：
RANDALL, WC
DOI：
10.1007/s10840-005-2492-2
发表时间：
2005-08-01
影响因子：
1.8
作者：
Scherlag, BJ;Nakagawa, H;Lazzara, R
通讯作者：
Lazzara, R
影响因子：
5.5
作者：
Po, SS;Scherlag, BJ;Jackman, WM
通讯作者：
Jackman, WM
影响因子：
37.8
作者：
Scanavacca, Mauricio;Pisani, Cristiano F.;Sosa, Eduardo
通讯作者：
Sosa, Eduardo