Burnett D, Abi-Samra F, Vacek J L
Cardiology Section, Alton Oschner Medical Institutions, New Orleans, LA, USA.
Am Heart J. 1999 Mar;137(3):435-8. doi: 10.1016/s0002-8703(99)70488-6.
Testing for sick sinus syndrome (SSS) requires invasive stimulation protocols for sinus node recovery time (SNRT) and corrected sinus node recovery time (CSNRT).
We compared the CSNRT with the lengthening of the sinus cycle length (ADO:SCL) corrected to the basic cycle length (ADO:CSNRT) after administration of an intravenous bolus of adenosine (0.15 mg/kg) in 10 patients with clinical SSS (group 1) and 67 control patients (group 2). With 550 ms as an abnormal result for the ADO:CSNRT (and for the CSNRT) as an indicator of sinus node dysfunction, the ADO:CSNRT had a sensitivity of 80% and specificity of 97% for detection of SSS compared with sensitivity and specificity of 70% and 95% for invasive CSNRT. When combined, the 2 tests had a sensitivity of 100%. There was significant difference in the CSNRT between group 1 (1848 +/- 1825 ms) and group 2 (355 +/- 169 ms, P <. 0001) and a significant difference in ADO:CSNRT between group 1 (1168 +/- 1002 ms) and group 2 (272 +/- 592 ms, P <.0001).
We conclude that the ADO:CSNRT is a sensitive and specific test for SSS that equals invasive testing and should be considered as an alternative to invasive testing in patients with suspected SSS.
病态窦房结综合征（SSS）的检测需要采用侵入性刺激方案来测定窦房结恢复时间（SNRT）和校正窦房结恢复时间（CSNRT）。
我们比较了10例临床诊断为SSS的患者（第1组）和67例对照患者（第2组）在静脉推注腺苷（0.15mg/kg）后校正至基础周期长度的窦房结周期长度延长值（ADO:SCL）与校正窦房结恢复时间（ADO:CSNRT）。以550ms作为ADO:CSNRT（以及CSNRT）异常结果作为窦房结功能障碍的指标，与侵入性CSNRT的敏感性70%和特异性95%相比，ADO:CSNRT检测SSS的敏感性为80%，特异性为97%。两者联合检测时，敏感性为100%。第1组（1848±1825ms）与第2组（355±169ms，P<.0001）的CSNRT存在显著差异，第1组（1168±1002ms）与第2组（272±592ms，P<.0001）的ADO:CSNRT也存在显著差异。
我们得出结论，ADO:CSNRT是一种检测SSS的敏感且特异的方法，与侵入性检测相当，对于疑似SSS的患者应考虑作为侵入性检测的替代方法。
