ANALYSIS OF CHAOS OF ATRIAL FIBRILLATION USING RR-INTERVAL PLOTTING

用 RR 区间作图分析心房颤动的混沌

• 批准号: 08670799
• 负责人: CHISHAKI Akiko
• 金额: $ 1.34万
• 依托单位: KYUSHU UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08670799/
• 关键词: Atrial fibrillation; RR-interval plotting; ventricular arrhythmias; prognosis; ventricular function; 生命予後; 変行伝導; 房室結節不応期; 自律神経機能

[Background] There is considerable evidence that the presence of ventricular ectopies (VEs) predicts mortality after acute myocardial infarction or other heart diseases. Those results, however, were obtained from the study population only to patients with the ordinary sinus rhythm and excluded patients with atrial fibrillation (AF), since the diagnosis of wide QRS complexes in AF as aberrant ventricular conductions or as VEs was difficult by surface electrocardiograms (ECGs). If we can diagnose the wide QRS complexes in AF by non-invasive method, the ventricular arrhythmias in AF can be studied more precisely and the clinical pictures of patients with ventricular arrhythmias in AF would be also elucidated. In a previous study, we introduced a non-invasive method that allowed us to differentiate aberrant ventricular conductions and VEs in AF using an RR-interval scatter diagram. The RR- interval scatter diagram is obtained by successively plotting the sequential pairs of RR-intervals re … More corded on Holter ECG monitoring. Since the plotting of aberrant ventricular conductions and VEs distributes differently on the RR- interval scatter diagram, we can diagnose the wide QRS complexes non-invasively. Furthermore, this method enables us to analyze the detailed characteristics of VEs in AF.The aim of this investigation was to analyze the modality of occurrence of ventricular arrhythmias in AF precisely using the RR-interval scatter diagram and to discover any relationship between the characteristics of ventricular arrhythmias and the clinical pictures of the AF- patients with VEs, especially one which would indicate the severity of cardiac function.[Methods] We successively plotted the points on X-Y plane as (X,Y)=(RRn, RRn+1), from the consecutive RR intervals in Holier ECG.We diagnosed 80 VEs from 175 AF-patients based on the different plotting patterns of VEs and aberration.[Results] The variability of coupling intervals of VEs observed in sinus rhythm also existed in those of VEs in AF, ie., fixed coupling (n=43) and variable coupling (n=37). Severe arrhythmias like sustained ventricular tachycardia and ventricular fibrillation occurred more frequently in the patients with variable coupling VEs than in those with fixed coupling VEs. Furthermore, analyzing the influence of a preceding sequence of RR-intervals on the occurrence of VEs, two types of preceding sequences existed, i.e., a short-long RR sequence (n=50) and no regular RR sequence (n=30) before VEs. Severe arrhythmias occurred in the group without regular preceding RR-interval sequence.[Conclusions) The RR-interval plotting enables us to differentiate the variable types of VEs and to analyze the relation between the types of VEs and the clinical characteristics in AF.Certain types of VEs in coupling interval and preceding RR-interval related to the severe ventricular arrhythmias. Less

[研究背景]大量证据表明，心室异位（ventricular ectopies，VE）的存在预示着急性心肌梗死或其他心脏病患者的死亡率。然而，这些结果仅来自于普通窦性心律患者的研究人群，排除了房颤（AF）患者，因为通过体表心电图（ECG）难以将AF中的宽QRS波群诊断为异常心室传导或VE。如果能无创性地诊断房颤的宽QRS波群，将有助于更准确地研究房颤的室性心律失常，并阐明房颤室性心律失常患者的临床表现。在以前的研究中，我们介绍了一种非侵入性的方法，使我们能够区分异常心室传导和室性心动过速在AF使用RR间期散点图。RR间期散点图是通过连续绘制RR间期序列对来获得的。 ...更多信息 记录在霍尔特心电图监测仪上。由于异常心室传导和室性心动过速在RR间期散点图上的分布不同，我们可以无创地诊断宽QRS波群。此外，这种方法使我们能够分析详细的特点，在房颤中的VE。本研究的目的是分析的方式，在AF室性心律失常的发生，精确地使用RR间期散点图，并发现室性心律失常的特点和AF患者的临床图片与VE之间的任何关系，特别是一个将表明心脏功能的严重程度。[方法]将Holier心电图上连续的RR间期在X-Y平面上按（X，Y）=（RRn，RRn+1）的顺序作图，根据不同的VEs和畸变图形诊断175例AF患者的80个VEs。[结果]窦性心律时所观察到的室性心动过速的偶联间期的变异性也存在于房颤时的室性心动过速的偶联间期中，固定耦合（n=43）和可变耦合（n=37）。可变耦联型室性心动过速、室颤等严重心律失常的发生率明显高于固定耦联型。此外，分析RR间期的前导序列对VE发生的影响，存在两种类型的前导序列，即，短-长RR序列（n=50）和VE前无规则RR序列（n=30）。无规律RR间期序列组发生严重心律失常。[结论] RR间期作图法可区分不同类型的室性心动过速，并分析其与临床特征的关系，某些类型的室性心动过速在偶联间期和RR间期前与严重室性心律失常有关。少

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