Guzik Przemyslaw, Piskorski Jaroslaw, Barthel Petra, Bauer Axel, Müller Alexander, Junk Nadine, Ulm Kurt, Malik Marek, Schmidt Georg
Department of Cardiology-Intensive Therapy, University of Medical Sciences in Poznan, Poland.
J Electrocardiol. 2012 Jan-Feb;45(1):70-6. doi: 10.1016/j.jelectrocard.2011.08.006. Epub 2011 Sep 14.
A method for counting episodes of uninterrupted beat-to-beat heart rate decelerations was developed.
The method was set up and evaluated using 24-hour electrocardiogram Holter recordings of 1455 (training sample) and 946 (validation sample) postinfarction patients. During a median follow-up of 24 months, 70, 46, and 19 patients of the training sample suffered from total, cardiac, and sudden cardiac mortality, respectively. In the validation sample, these numbers were 39, 25, and 15. Episodes of consecutive beat-to-beat heart rate decelerations (deceleration runs [DRs]) were characterized by their length.
Deceleration runs of 2 to 10 cycles were significantly less frequent in nonsurvivors. Multivariate model of DRs of 2, 4, and 8 cycles identified low-, intermediate-, and high-risk groups. In these groups of the training sample, the total mortalities were 1.8%, 6.1%, and 24%, respectively. In the validation sample, these numbers were 1.8%, 4.1%, and 21.9%.
Infrequent DRs during 24-hour Holter indicate high risk of postinfarction mortality.
开发了一种用于计算逐搏心率减速连续发作次数的方法。
使用1455例（训练样本）和946例（验证样本）心肌梗死后患者的24小时动态心电图Holter记录来建立和评估该方法。在中位随访24个月期间，训练样本中的70例、46例和19例患者分别死于全因死亡、心脏死亡和心源性猝死。在验证样本中，这些数字分别为39例、25例和15例。连续逐搏心率减速发作（减速序列[DRs]）以其长度为特征。
非幸存者中2至10个周期的减速序列明显较少见。2个、4个和8个周期的DRs多变量模型确定了低、中、高风险组。在训练样本的这些组中，全因死亡率分别为1.8%、6.1%和24%。在验证样本中，这些数字分别为1.8%、4.1%和21.9%。
24小时动态心电图期间DRs不常见表明心肌梗死后死亡风险高。
