Viskin S, Golovner M, Malov N, Fish R, Alroy I, Vila Y, Laniado S, Kaplinsky E, Roth A
Department of Cardiology, Sourasky, Tel Aviv and Sheba, Israel.
Eur Heart J. 1999 Oct;20(19):1429-34. doi: 10.1053/euhj.1999.1632.
To determine the circadian rhythm of paroxysmal atrial fibrillation in a very large outpatient population.
We reviewed all emergency telephone calls received in Shahal (a medical service covering 44 000 subscribers), from 1987 to 1997. Patients were included if new-onset atrial fibrillation was recorded. During this study period, 9989 episodes of paroxysmal atrial fibrillation were recorded. The time of onset was not uniformly distributed throughout the 24 h period. Instead, the distribution of arrhythmic episodes showed a double peak, with a significant increase in the number of episodes in the morning and a second rise in the evening (P<0.001). A non-uniform weekly distribution of events was also noted, with substantially fewer episodes on Saturdays (P<0.001). Finally, more arrhythmias occurred during the last months of each year (P<0.001).
The onset of paroxysmal atrial fibrillation does not occur randomly. The large patient population in the present study suggests that the circadian rhythm of paroxysmal atrial fibrillation is similar to that described for other cardiovascular diseases, with clustering of events in the morning and (to a lesser degree) late in the evening. Weekly and yearly circadian patterns are also prominent.
确定非常大的门诊人群中阵发性心房颤动的昼夜节律。
我们回顾了1987年至1997年在沙哈尔（一项覆盖44000名订阅者的医疗服务）接到的所有紧急电话。如果记录到新发心房颤动，则纳入患者。在本研究期间，记录了9989次阵发性心房颤动发作。发作时间在24小时内并非均匀分布。相反，心律失常发作的分布呈现双峰，早晨发作次数显著增加，晚上出现第二次高峰（P<0.001）。还注意到事件的每周分布不均匀，周六的发作次数明显较少（P<0.001）。最后，每年的最后几个月心律失常发作更多（P<0.001）。
阵发性心房颤动的发作并非随机发生。本研究中的大量患者表明，阵发性心房颤动的昼夜节律与其他心血管疾病相似，发作集中在早晨和（程度较轻）晚上。每周和每年的昼夜模式也很明显。
