Pérez-Rodon Jordi, Martínez-Alday Jesus, Barón-Esquivias Gonzalo, Martín Alfonso, García-Civera Roberto, Del Arco Carmen, Cano-Gonzalez Alicia, Moya-Mitjans Angel
Arrhythmia Unit, Department of Cardiology, Hospital Universitari Vall d'Hebrón, Universitat Autònoma de Barcelona, Spain.
Arrhythmia Unit, Department of Cardiology, Hospital de Basurto, Bilbao, Spain.
Heart Rhythm. 2014 Nov;11(11):2035-44. doi: 10.1016/j.hrthm.2014.06.037. Epub 2014 Jun 30.
The Group for Syncope Study in the Emergency Room (GESINUR) was a Spanish multicenter, prospective, observational study that evaluated the clinical presentation and acute management of loss of consciousness in Spain. Several studies have shown that an abnormal ECG is a poor prognostic factor in patients with syncope. However, the prognostic significance of each ECG abnormality is not well known.
The purpose of this study was to study the association between specific ECG abnormalities and mortality in patients with syncope from the GESINUR study.
All patients in the GESINUR study who had syncope and had available, readable ECG and 12-month follow-up data were included in this retrospective observational study (n = 524, age 57 ± 22 years, 50.6% male). ECG abnormalities were analyzed and assessed to evaluate whether an association with all-cause mortality existed at 12 months.
ECGs were classified as abnormal in 344 patients (65.6%). Thirty-three patients died during follow-up (6.3%), but only 1 due to sudden cardiovascular death. Atrial fibrillation (odds ratio [OR] 6.8, 95% confidence interval [CI] 2.8-16.3, P <.001), intraventricular conduction disturbances (OR 3.8, 95% CI 1.7-8.3, P = .001), left ventricular hypertrophy ECG criteria (OR 6.3, 95% CI 1.5-26.3, P = .011), and ventricular pacing (OR 21.8, 95% CI 4.1-115.3, P <.001) were the only independent ECG predictors of all-cause mortality.
Although an abnormal ECG in patients with syncope is a common finding, only the presence of atrial fibrillation, intraventricular conduction disturbances, left ventricular hypertrophy ECG criteria, and ventricular pacing is associated with 1-year all-cause mortality.
急诊室晕厥研究小组（GESINUR）是一项西班牙多中心、前瞻性观察性研究，旨在评估西班牙意识丧失的临床表现和急性处理情况。多项研究表明，心电图异常是晕厥患者预后不良的因素。然而，每种心电图异常的预后意义尚不明确。
本研究旨在探讨GESINUR研究中晕厥患者特定心电图异常与死亡率之间的关联。
本回顾性观察性研究纳入了GESINUR研究中所有有晕厥症状、有可用且可读心电图以及12个月随访数据的患者（n = 524，年龄57±22岁，男性占50.6%）。对心电图异常进行分析和评估，以判断其与12个月全因死亡率是否存在关联。
344例患者（65.6%）的心电图被分类为异常。33例患者在随访期间死亡（6.3%），但仅1例死于心源性猝死。心房颤动（比值比[OR] 6.8，95%置信区间[CI] 2.8 - 16.3，P <.001）、室内传导障碍（OR 3.8，95% CI 1.7 - 8.3，P =.001）、左心室肥厚心电图标准（OR 6.3，95% CI 1.5 - 26.3，P =.011）和心室起搏（OR 21.8，95% CI 4.1 - 115.3，P <.001）是全因死亡率的唯一独立心电图预测因素。
虽然晕厥患者心电图异常很常见，但仅心房颤动、室内传导障碍、左心室肥厚心电图标准和心室起搏的存在与1年全因死亡率相关。
