Valkama J O, Huikuri H V, Linnaluoto M K, Takkunen J T
Department of Medicine, Oulu University Central Hospital, Finland.
Int J Cardiol. 1992 Feb;34(2):173-8. doi: 10.1016/0167-5273(92)90153-t.
Sudden cardiac death and ischaemic cardiac events occur in a circadian pattern. Because ventricular tachycardia is thought to play an important role in sudden cardiac death, the episodes of spontaneous ventricular tachycardias (greater than 3 consecutive beats) (n = 1314) were analysed from 24-hour long term electrocardiographic recordings in 34 patients with coronary arterial disease to determine whether circadian rhythm exists in spontaneous ventricular tachycardia. Twelve patients had suffered cardiac arrest, four patients had a history of syncope, and palpitation was the indication for electrocardiographic recordings in eighteen patients. Analysis using chronobiologic single cosinor method showed a significant circadian variation in the occurrence of ventricular tachycardia episodes with the peak occurring at 6 a.m. Similar circadian rhythm was also observed in the occurrence of the longest episode of ventricular tachycardia. Ischaemic ST-segment depression preceded the longest ventricular tachycardia episode only in one patient. Thus, a circadian rhythm occurs also in spontaneous episodes of ventricular tachycardia, a finding which is similar to that in sudden cardiac death.
心脏性猝死和缺血性心脏事件呈昼夜节律模式发生。由于室性心动过速被认为在心脏性猝死中起重要作用，因此对34例冠状动脉疾病患者进行了24小时长期心电图记录，分析了自发性室性心动过速（连续3次以上搏动）发作（n = 1314）情况，以确定自发性室性心动过速是否存在昼夜节律。12例患者曾发生心脏骤停，4例患者有晕厥病史，18例患者因心悸接受心电图记录。采用时间生物学单余弦法分析显示，室性心动过速发作的发生存在显著的昼夜变化，峰值出现在上午6点。在最长室性心动过速发作的发生中也观察到类似的昼夜节律。仅1例患者在最长室性心动过速发作之前出现缺血性ST段压低。因此，自发性室性心动过速发作也存在昼夜节律，这一发现与心脏性猝死的情况相似。
