PREVALENCE OF ARRHYTHMIAS DURING 24-HOUR ELECTROCARDIOGRAPHIC MONITORING AND EXERCISE TESTING IN PATIENTS WITH OBSTRUCTIVE AND NONOBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY
PREVALENCE OF ARRHYTHMIAS DURING 24-HOUR ELECTROCARDIOGRAPHIC MONITORING AND EXERCISE TESTING IN PATIENTS WITH OBSTRUCTIVE AND NONOBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY
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DOI：
10.1161/01.cir.59.5.866
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发表时间：
1979-01-01
期刊：
影响因子：
37.8
通讯作者：
EPSTEIN, SE
中科院分区：
文献类型：
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作者：
SAVAGE, DD;SEIDES, SF;EPSTEIN, SE
许多肥厚性心肌病患者突然意外死亡，其中很大一部分可能是由于心律失常。在最初评估的100例患者中，有提示心脏病或肥厚性心肌病家族史的体征或症状，51例患者通过超声心动图的疾病标准被选中，49例患者被选中，因为他们有正常的窦性心律，尽管左房扩大，有晕厥史，有过早死亡家族史或阵发性心房颤动史。所有100例患者均通过24小时动态心电图监测进行研究，74例患者也进行了跑步机运动试验。所有亚组中超过50%的患者（有或无症状或左心室流出道梗阻）有多种形式或重复的心室过早去极化，包括19%的室性心动过速。在暴露这些心律失常方面，监测优于运动试验。2例患者在监测后2个月内出现心脏骤停；两例监测均显示室性心动过速。监测期间有2例室上性心动过速发作的患者在1年内发展为固定房颤。监测可能有助于识别显著心律失常事件风险增加的患者。
Many patients with hypertrophic cardiomyopathy die suddenly and unexpectedly, a significant number may be perhaps due to arrhythmia. Of 100 patients initially evaluated for signs or symptoms suggestive of heart disease or a family history of hypertrophic cardiomyopathy, 51 were selected by echocardiographic criteria for the disease and 49 patients were selected because they had normal sinus rhythm despite left atrial enlargement, a history of syncope, a family history of premature death or a history of paroxysmal atrial fibrillation. All 100 patients were studied by 24 h ambulatory ECG monitoring and 74 also underwent treadmill exercise testing. More than 50% of patients in all subgroups (with or without symptoms or left ventricular outflow tract obstruction) had multiform or repetitive ventricular premature depolarizations, including 19% who had ventricular tachycardia. Monitoring was superior to exercise testing for exposing these arrhythmias. Two patients experienced cardiac arrest within 2 mo. of monitoring; in each, monitoring revealed ventricular tachycardia. Two patients with paroxysms of supraventricular tachycardia during monitoring developed fixed atrial fibrillation within 1 yr. Monitoring may help identify patients at increased risk for significant arrhythmic events.