Analysis of ambulatory electrocardiograms in 15 patients during spontaneous ventricular fibrillation with special reference to preceding arrhythmic events.
Analysis of ambulatory electrocardiograms in 15 patients during spontaneous ventricular fibrillation with special reference to preceding arrhythmic events.
复制标题
对 15 名自发性心室颤动患者的动态心电图进行分析，特别参考之前的心律失常事件。
DOI：
10.1016/s0735-1097(83)80224-1
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发表时间：
1983
影响因子：
24
通讯作者：
Quinones,MA
中科院分区：
文献类型：
--
作者：
Pratt,CM;Francis,MJ;Luck,JC;Wyndham,CR;Miller,RR;Quinones,MA
在3.5年的动态心电图记录中，有15例患者持续心室颤动，分析了16,500例动态心电图（患病率= 0.09%或1/1,100）。8名患者死亡，7名通过心肺复苏存活。心室颤动前每小时室性心律失常的定量分析显示室性早搏和室性心动过速的频率增加，特别是在心室颤动前2小时。所有15例均由室性心动过速引起心室颤动。这些室性心动过速的特点是时间长（平均= 560±536次），速度快（241±45次/分）。虽然T次室性早搏偶尔会引发室性心动过速和室颤，但室性早搏的平均早产指数并不早（平均= 1.27±0.28）。15例患者中仅有3例出现QT延长（平均QTc间期= 0.42±0.06）。左心室功能障碍（平均左心室射血分数= 34.9±9.9%）和冠状动脉疾病几乎都存在。在心室颤动时与这些患者最常相关的心脏药物是洋地黄和奎尼丁。
Fifteen patients sustained ventricular fibrillation during ambulatory electrocardiographic recording in a period of 3.5 years over which time 16,500 ambulatory electrocardiograms were analyzed (prevalence = 0.09% or 1/1,100). Eight patients died, and seven survived cardiopulmonary resuscitation. Quantitative analysis of hourly ventricular arrhythmias prior to ventricular fibrillation revealed an increased frequency of premature ventricular beats and ventricular tachycardia, especially in the 2 hours immediately before ventricular fibrillation. Ventricular fibrillation was initiated by ventricular tachycardia in all 15 cases. These runs of ventricular tachycardia were characterized by their unusual length (mean = 560 ± 536 beats) and their rapid rate (241 ± 45 beats/min). Although an R on T premature ventricular beat initiated ventricular tachycardia and ventricular fibrillation occasionally, the mean prematurity index of the initiating premature ventricular beat was not early (mean = 1.27 ± 0.28). QT prolongation was present in only 3 of the 15 patients (mean QTc interval = 0.42 ± 0.06). Left ventricular dysfunction (mean left ventricular ejection fraction = 34.9 ± 9.9%) and coronary artery disease were nearly always present. The cardiac medications most frequently associated with these patients at the time of ventricular fibrillation were digitalis and quinidine.