动态心电图监测、窦房传导时间、预后。

Holter monitoring, sinoatrial conduction time, prognosis.

机构信息

Internal Medicine and Car diology Department, Military Institute of Medicine, Warsaw, Poland.

出版信息

Cardiol J. 2013;20(5):539-44. doi: 10.5603/CJ.2013.0140.

DOI:10.5603/CJ.2013.0140

PMID:24469879

Abstract

BACKGROUND

To evaluate the usefulness of the Holter method of sinoatrial conduction time (SACT) calculation in predicting the future occurrence of sinus node disease, and the emergence of indications for permanent pacing in patients with unexplained syncope.

METHODS

The study group included 218 patients (mean age 55 ± 17 years, 116 men) with syncope of unknown etiology in whom spontaneous atrial premature depolarizations (APDs) occurred during Holter monitoring and SACT could be calculated. A SACT value during daily activity > 150 ms was assumed as abnormal.

RESULTS

The prospective observation time was 48 ± 11 months. During follow-up sinus node disease was diagnosed in 22 persons, including 18 patients with baseline SACT > 150 ms and 4 with SACT < 150 ms. Indications for pacemaker implantation were found in 16 patients, including 13 patients with baseline SACT > 150 ms and 3 with SACT < 150 ms. In subjects with and without sinus node disease diagnosed during the observation period, baseline SACTvalues were 175 ± 52 ms and 87 ± 34 ms, respectively (p < 0.01), and in patients qualified and not qualified for permanent pacing, the respective values were 178 ± 59 ms and 81 ± 38 ms(p < 0.01). Multivariate Cox analysis showed a significant relationship between baseline SACT > 150 ms and a future diagnosis of sinus node disease and pacemaker implantation.

CONCLUSIONS

The results suggest that the Holter method of SACT calculation is useful in predicting sinus node disease and indications for permanent pacing in patients with unexplained syncope.

摘要

背景

评估动态心电图（Holter）测量窦房结传导时间（SACT）在预测不明原因晕厥患者未来发生窦房结疾病和出现永久性起搏指征中的作用。

方法

研究组纳入 218 例（平均年龄 55 ± 17 岁，男性 116 例）不明原因晕厥且 Holter 监测时出现自发性房性期前收缩（APD）并能计算 SACT 的患者。假设日常活动中 SACT 值>150 ms 为异常。

结果

前瞻性观察时间为 48 ± 11 个月。随访期间诊断为窦房结疾病 22 例，其中基线 SACT >150 ms 18 例，SACT <150 ms 4 例。发现起搏器植入指征 16 例，其中基线 SACT >150 ms 13 例，SACT <150 ms 3 例。在观察期间诊断为和未诊断为窦房结疾病的患者，基线 SACT 值分别为 175 ± 52 ms 和 87 ± 34 ms（p <0.01），有资格和无资格接受永久性起搏的患者，各自的 SACT 值分别为 178 ± 59 ms 和 81 ± 38 ms（p <0.01）。多变量 Cox 分析显示，基线 SACT >150 ms 与未来诊断为窦房结疾病和需要起搏器植入显著相关。