| 摘要: |
| 目的观察不同联律间期室性期前收缩刺激对窦性心率震荡的影响。方法对20例阵发性室上性心动过速（PSVT）患者，分别通过动态心电图行自发性心率震荡检测和通过心室程序刺激行诱发性心率震荡检测，比较不同联律间期室性期前收缩刺激所诱发的窦性心率震荡参数[震荡初始（TO）和震荡斜率（TS）]的差异。结果自发性窦性心率震荡[（-2.29±1.47）%、（10.14±5.71）ms/R-R]与诱发性窦性心率震荡[（-1.71±1.36）%、（7.12±4.68）ms/R-R]比较，差异均无统计学意义（均P＞0.05），右心室心尖部、右心室流出道室性期前收缩的联律间期与诱发性窦性心率震荡参数TO和TS均有较好的相关性（r＝-0.825、-0.793、-0.712、-0.689，P＜0.01）。结论诱发性窦性心率震荡与自发性窦性心率震荡具有一致性，心室不同刺激部位对诱发性窦性心率震荡结果无明显影响，室性期前收缩的联律间期与诱发性窦性心率震荡参数有相关性，动态心电图记录中心室不同部位和不同联律间期的室性期前收缩所计算的心率震荡参数值均有较高的可信度。 |
| 关键词: 心率震荡 程序性刺激 室性期前收缩 偶联间期 |
| DOI： |
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| Influence of coupling interval on heart rate turbulence induced by programmed ventricular stimuli |
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XU Guidong, LI Yuan, WANG Lin, MA Xuexing, YAO Jinliang, CHEN Lu, HAN Zhen, WANG Xi
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Suzhou Municipal hospital
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| Abstract: |
| Objective To investigate the influence of coupling interval on heart rate turbulence (HRT) induced by programmed ventricular stimuli. Methods Spontaneous HRT derived from extra ventricular beats extracted from Holter ECG and induced HRT from extra ventricular beats extracted from programmed ventricular stimuli were studied and the turbulence onset (TO) and turbulence slope (TS) were compared in 20 patients with paroxysmal supraventricular tachycardia (PSVT). Prematurity started at 450 ms and was decreased to the refractoriness of each site. TO and TS were computed and correlated to the site of origin and the coupling interval (CI). Results There were no significant differences in turbulence onset (-1.71±1.36% vs -2.29±1.47%, P ＝0.12), turbulence slope (7.12±4.68 ms/RR vs 10.14±5.71 ms/RR, P＝0.75)between induced and spontaneous HRT. TO and TS induced in both ventricular sites were correlated with the coupling interval (TO:RVAP r＝-0.825, P＜0.01;RVOT r＝-0.793,P＜0.01 and TS:RVAP r＝
-0.712,P ＜0.01;RVOT r ＝-0.689,P ＜0.01). Conclusion Heart rate turbulence induced in the electrophysiology laboratory were similar to those following spontaneous PVCs. The site of origin of the ventricular premature beat exhibits no influence on heart rate turbulence onset and slope. The prematurity of the extra ventricular beat correlates with turbulence onset and slope. Therefore,the calculation of heart rate turbulence derived from extra ventricular beats extracted from Holter ECG is reliable. |
| Key words: Heart rate turbulence Programmed stimuli Premature ventricular beat Coupling interval |
