Heart rate dynamics at the onset of ventricular tachyarrhythmias as retrieved from implantable cardioverter-defibrillators in patients with coronary artery disease
Heart rate dynamics at the onset of ventricular tachyarrhythmias as retrieved from implantable cardioverter-defibrillators in patients with coronary artery disease
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DOI：
10.1161/01.cir.101.20.2398
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发表时间：
2000-05-23
期刊：
影响因子：
37.8
通讯作者：
Fromer, M
中科院分区：
文献类型：
--
作者：
Pruvot, E;Thonet, G;Fromer, M
背景-最近可获得的可记录室性快速性心律失常（VTA）前1024个R-R间期的植入式心律转复除颤器（ICD）为分析VTA发作前的心率变异性（HRV）提供了一个独特的机会。方法和结果-58名因复发VTA而植入ICD的心肌梗死后患者提供了2组98个窦性心律心率记录：（1）在VTA之前和（2）在控制条件期间。根据抗肿瘤（AA）药物方案，考虑了三个亚组。与对照组相比，VTA发作前HRV显著降低，提示交感神经兴奋状态。β-受体阻滞剂和dl-索他洛尔增强对照记录的HRV;然而，独立于AA药物，VTA前HRV下降。在VTA发病的心率和窦性心律不齐的减少逐渐增加的患者接受DL-索他洛尔的具体调查结果。结论VTA发病前观察到的奇特的心率动力学提示交感神经兴奋的状态，是独立的AA药物。
Background-The recent availability of implantable cardioverter-defibrillators (ICDs) that record 1024 R-R intervals preceding a ventricular tachyarrhythmia (VTA) provides a unique opportunity to analyze heart rate variability (HRV) before the onset of VTA.Methods and Results-Fifty-eight post-myocardial infarction patients with an implanted ICD for recurrent VTA provided 2 sets of 98 heart rate recordings in sinus rhythm: (1) before a VTA and (2) during control conditions. Three subgroups were considered according to the antiarrhythmic (AA) drug regimen. A state of sympathoexcitation was suggested by the significant reduction in HRV before VTA onset compared with control conditions. beta-Blockers and dl-sotalol enhanced HRV in control recordings; nevertheless, HRV declined before VTA independent of AA drugs. A gradual increase in heart rate and decrease in sinus arrhythmia at VTA onset were specific findings of patients who received dl-sotalol.Conclusions-The peculiar heart rate dynamics observed before VTA onset are suggestive of a state of sympathoexcitation that is independent of AA drugs.