Cardiology Clinic, Polytechnic University of Marche Region, 60100 Ancona, Italy.
Europace. 2012 Aug;14(8):1117-24. doi: 10.1093/europace/eus038. Epub 2012 Mar 9.
Disorders such as paroxysmal atrial fibrillation (AF) and atrial tachyarrhythmias (AT) are difficult to investigate because of their intermittent, and sometimes asymptomatic, nature. The aim of this study was to investigate the daily temporal distribution of AT/AF episodes--onset and occurrence--by analysing data from 250 pacemaker-implanted, brady-tachy syndrome patients who have been enrolled in the Burden II Study.
Data were analysed accounting for the mode switch list which includes date, time, and duration of each mode switch episode. Chi-squared tests for goodness of fit were used to determine whether AT/AF episode were uniformly distributed. The population analysed in the present study suggests the occurrence of a circadian rhythm of paroxysmal AF episodes, similar to that described for other cardiovascular diseases, with clustering of events in the morning from 08:00 and (to a lesser degree) in the afternoon (03:00 to 18:00). The relative risk of AT/AF onset is 13% higher during daytime, 40% lower at night (P < 0.000001).
The use of monitoring devices based on daily electrocardiogram (ECG) recording could be optimized with these data, thus increasing the probability to detect AT/AF episodes.
阵发性心房颤动（AF）和房性心动过速（AT）等疾病因其间歇性和有时无症状的特点，难以进行研究。本研究旨在通过分析 250 例植入起搏器的缓慢性心律失常综合征患者的 Burden II 研究数据，探讨 AT/AF 发作的每日时间分布 - 发作和发生。
分析数据时考虑了模式转换列表，其中包括每个模式转换发作的日期、时间和持续时间。卡方检验用于确定 AT/AF 发作是否均匀分布。本研究分析的人群提示阵发性 AF 发作存在昼夜节律，类似于其他心血管疾病描述的节律，事件在早晨 8 点聚集（程度较轻），下午 3 点至 18 点。白天 AT/AF 发作的相对风险增加 13%，夜间降低 40%（P < 0.000001）。
这些数据可优化基于每日心电图（ECG）记录的监测设备的使用，从而增加检测 AT/AF 发作的概率。
