Nigro Gerardo, Russo Vincenzo, de Chiara Annabella, Rago Anna, Cioppa Nadia Della, Chianese Raffaele, Manfredi Donatella, Calabrò Raffaele
Chair of Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy.
Ann Noninvasive Electrocardiol. 2010 Jan;15(1):49-55. doi: 10.1111/j.1542-474X.2009.00339.x.
Our study was designed to analyze dynamic changes in autonomic tone before the onset of typical sustained atrioventricular nodal reentry tachycardia (AVNRT) in a large group of patients without structural heart disease.
Twenty-four-hour Holter tapes from 42 consecutive patients (27 men and 15 women; aged 30 + or - 21 years) with several episodes of sustained typical AVNRT were analyzed. The diagnosis was validated by transesophageal electrophysiological study. The time-domain calculated parameters were SDNN, SDANN, rMSSD, pNN50; the frequency-domain parameters were low-frequency power (LF, 0.04-0.15 Hz), high-frequency power (HF, 0.15-0.40 Hz), very low-frequency power (VLF, 0.008 to 0.04 Hz) and LF/HF. The mean values in the hour before the onset of sustained AVNRT were compared with the mean values of 2 hours before and 1 hour after the onset of sustained AVNRT.
The mean SDNN, rMSSD, pNN50, HF were significantly decreased during the hour preceding the onset of AVNRT, when compared to the mean values observed during the time periods selected. Instead, the LF values and LF/HF were increased before the onset of sustained AVNRT. No significant change in the VLF and atrial ectopic beats were observed.
This study suggests that sustained typical AVNRT episodes are preceded by increase in adrenergic drive.
我们的研究旨在分析一大组无结构性心脏病患者在典型持续性房室结折返性心动过速（AVNRT）发作前自主神经张力的动态变化。
对42例连续发作数次持续性典型AVNRT的患者（27例男性和15例女性；年龄30±21岁）的24小时动态心电图进行分析。经食管电生理研究验证诊断。时域计算参数为SDNN、SDANN、rMSSD、pNN50；频域参数为低频功率（LF，0.04 - 0.15 Hz）、高频功率（HF，0.15 - 0.40 Hz）、极低频功率（VLF，0.008至0.04 Hz）和LF/HF。将持续性AVNRT发作前1小时的平均值与发作前2小时和发作后1小时的平均值进行比较。
与所选时间段观察到的平均值相比，AVNRT发作前1小时的平均SDNN、rMSSD、pNN50、HF显著降低。相反，持续性AVNRT发作前LF值和LF/HF升高。VLF和房性早搏未见显著变化。
本研究表明，持续性典型AVNRT发作前肾上腺素能驱动增加。
