University of Virginia Health System, Charlottesville, VA 22908, USA.
Am J Emerg Med. 2011 Jun;29(5):545-8. doi: 10.1016/j.ajem.2010.01.041. Epub 2010 May 1.
Paroxysmal supraventricular tachycardia (PSVT), a common dysrhythmia seen in the emergency department (ED), is usually managed without difficulty and with a favorable prognosis. Serum cardiac troponin I (cTnI) testing provides important risk stratification information in certain patients; its use in PSVT patients, however, has not been explored. A retrospective review of consecutive adult ED PSVT patients seen for 21 months was performed. Fifty-four PSVT patients were identified on the basis of International Classification of Disease, Ninth Edition codes and the ED patient log at a university hospital. Three patients were excluded for incorrect rhythm, leaving 51 who were included in data analysis. Thirty-eight patients had at least one serum cTnI value measured. Of those, 11 had a positive result, defined as serum cTnI of more than 0.02 ng/dL. Thirty-day outcomes for these patients were evaluated and showed one ED return, no PSVT recurrences, and no deaths at our regional hospital. In this sample, serum cTnI testing did not identify PSVT patients at risk for poor outcome. Further consideration of the use of this testing modality in the PSVT patient population is recommended.
阵发性室上性心动过速(PSVT)是急诊科常见的心律失常,通常不难治疗且预后良好。血清心肌肌钙蛋白 I(cTnI)检测可为某些患者提供重要的风险分层信息;然而,其在 PSVT 患者中的应用尚未得到探索。对 21 个月内连续就诊的成年急诊科 PSVT 患者进行了回顾性分析。根据国际疾病分类第 9 版编码和大学医院急诊科患者日志,确定了 54 例 PSVT 患者。因节律不正确而排除了 3 例患者,因此有 51 例患者纳入数据分析。38 例患者至少测量了一次血清 cTnI 值。其中,11 例结果阳性,定义为血清 cTnI 超过 0.02ng/dL。评估这些患者的 30 天结局显示,在我们的地区医院有 1 例患者返回急诊科,无 PSVT 复发,也无死亡。在该样本中,血清 cTnI 检测并未发现 PSVT 患者存在预后不良的风险。建议进一步考虑在 PSVT 患者人群中使用这种检测方法。