Karjalainen J, Viitasalo M
Arch Intern Med. 1986 Jun;146(6):1169-71.
To study the effect of fever on cardiac rhythm and conduction, we recorded 24-hour electrocardiograms in 27 young men during an uncomplicated acute febrile infection (12 patients had adenovirus, four had influenza, three had Mycoplasma pneumoniae, and eight were undefined) and after recovery. During the first 24-hour recording period, the mean axillary temperature in the whole group was 38.4 degrees C. The mean heart rate during the febrile period was 84.0 beats per minute. After recovery, it was 66.5 beats per minute. When the temperature rose by 1 degree C, the heart rate increased on the average by 8.5 beats per minute. During the febrile period, the heart rate remained high, even during sleep. The PR interval shortened significantly at a heart rate of 60 beats per minute and occasional first- or second-degree atrioventricular blocks were rarer. The QT interval shortened significantly at heart rates of 60, 80, and 100 beats per minute. Simple and complex ventricular extrasystoles were not increased by fever. In contrast, frequent supraventricular extrasystoles developed in two patients during high fever, but not during the control recording. If an acute febrile infection induces a prolongation of the atrioventricular conduction or the QT interval, or if frequent ventricular extrasystolic beats are triggered, complications must be suspected.
为研究发热对心律和传导的影响，我们记录了27名年轻男性在单纯急性发热感染期间（12例为腺病毒感染，4例为流感，3例为肺炎支原体感染，8例病因不明）及康复后的24小时心电图。在首个24小时记录期，全组平均腋窝温度为38.4摄氏度。发热期平均心率为每分钟84.0次。康复后，平均心率为每分钟66.5次。体温每升高1摄氏度，心率平均增加8.5次/分钟。在发热期，即使在睡眠期间心率仍保持较高水平。心率为每分钟60次时，PR间期显著缩短，偶发一度或二度房室传导阻滞较少见。心率为每分钟60次、80次和100次时，QT间期显著缩短。发热并未增加单纯性和复杂性室性期前收缩。相反，两名患者在高热期间出现频发室上性期前收缩，而在对照记录期间未出现。如果急性发热感染导致房室传导延长或QT间期延长，或者引发频发室性期前收缩，则必须怀疑有并发症。
