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頁籤選單縮合
題名 | Heart Rate Variability in Patients with Atrioventricular Block=在房室傳導阻斷之病人心率變異性的分析 |
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作者 | 蕭相江; 邱泓文; 李孝全; 高材; 張興亞; 江志桓; | 書刊名 | 中華醫學雜誌 |
卷期 | 60:2 1997.08[民86.08] |
頁次 | 頁81-85 |
分類號 | 415.3023 |
關鍵詞 | 房室傳導阻斷; 食道電極; 心率變異性; PP波間距; Atrioventricular block; Esophageal lead; Heart rate variability; PP intervals; |
語文 | 英文(English) |
中文摘要 | 背景:以體表心電圖測定RR波間距作為心率變異度的分析是對自主神經系統活動性的評估一種已被建立的方法。然而,房室節功能失調的病人,尤其患有特定度的房室傳導阻斷者,其RR波間距不適用於心率變異性的分析。在房室傳導阻斷的病人,我們運用食道電極測定PP波間距來分析心率變異性。 方法:研究對象包括13位房室傳導正常的人及7位房室傳導阻斷的病人。以食道電極、體表電極、及心房內電極記錄PP波或AA波的間距。分析從不同的電極測得之心率間距的相關係數,然後比較房室傳導正常者及房室傳導阻斷病人之間心率變異性的參數。 結果:房室傳導阻斷的病人,PP波的間距,在心房內心電圖和體表心電圖有較差的關 聯(r=0.499),然而,心房內心電圖和食道心電圖有極佳的關聯性(r=0.985)。房室傳導阻斷病人心率變異性在時間定義域有降低現象。房室傳導正常者與房室傳導阻斷病人的全部NN間距標準差(SDNN)分別為0.035±0.006及0.021±0.016秒(p=0.002);其pNN-5分別為3.210 ±3.120及0.050±0.040%(p=0.027);其r-MSSD分別為0.577±0.181及0.318±0.084秒 (p=0.009)。 結論:食道電極在偵測房室傳導阻斷病人的心率變異性是一種簡單和安全的非侵襲性方法;在房室傳導阻斷的病人有不正常的逃走神經活動性。 |
英文摘要 | Background: Heart rate variability (HRV) analysis has been an established method for assessment of the activities of autonomic nervous system. Conventionally, the RR intervals from the surface electrocardiogram (ECG) are used for HRV analysis, however, analysis of the RR intervals may not be suitable in patients with atrioventricular (AV) node dysfunction, particularly in patients with certain degree of AV block. We used an esophageal electrode to detect PP intervals for HRV analysis in these patients. Methods: Seven AV block patients and 13 subjects with normal AV conduction (control group) were enrolled in this study. The signals from esophageal lead, surface lead and intraatrial lead were recorded. Correlation coefficient of heart beat intervals from different leads was analyzed. Then we compared the HRV parameter recorded by esophageal lead between AV block patients and the control group. Results: The AA intervals in intraatrial ECG and the PP intervals in surface ECG were poorly correlated (r=0.489) in the AV block patients. However, intraatrial ECG was correlated well with esophageal ECG (r=0.968). HRV with time domain decreased significantly in patients with AV block. The standard deviation of NN intervals (SDNN), pNN-50 and r-MSSD in the control group and the AV block patients were 0.035 +/- 0.006 vs. 0.021 +/- 0.016 seconds (p = 0.002), 3.210 +/- 3.120 vs. 0.050 +/- 0.040 % (p = 0.027) and 0.577 +/- 0.181 vs. 0.318 +/- 0.084 seconds (p = 0.009), respectively. Conclusions: The esophageal lead recording is a non-invasive, easy and safe method to detect HRV of AV block patients whose vagal activity is abnormal. |
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