皮肤交感神经活动与心电图的同步无创记录。
Simultaneous noninvasive recording of skin sympathetic nerve activity and electrocardiogram.
作者信息
Doytchinova Anisiia, Hassel Jonathan L, Yuan Yuan, Lin Hongbo, Yin Dechun, Adams David, Straka Susan, Wright Keith, Smith Kimberly, Wagner David, Shen Changyu, Salanova Vicenta, Meshberger Chad, Chen Lan S, Kincaid John C, Coffey Arthur C, Wu Gang, Li Yan, Kovacs Richard J, Everett Thomas H, Victor Ronald, Cha Yong-Mei, Lin Shien-Fong, Chen Peng-Sheng
机构信息
Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
出版信息
Heart Rhythm. 2017 Jan;14(1):25-33. doi: 10.1016/j.hrthm.2016.09.019. Epub 2016 Sep 23.
BACKGROUND
Sympathetic nerve activity is important to cardiac arrhythmogenesis.
OBJECTIVE
The purpose of this study was to develop a method for simultaneous noninvasive recording of skin sympathetic nerve activity (SKNA) and electrocardiogram (ECG) using conventional ECG electrodes. This method (neuECG) can be used to adequately estimate sympathetic tone.
METHODS
We recorded neuECG signals from the skin of 56 human subjects. The signals were low-pass filtered to show the ECG and high-pass filtered to show nerve activity. Protocol 1 included 12 healthy volunteers who underwent cold water pressor test and Valsalva maneuver. Protocol 2 included 19 inpatients with epilepsy but without known heart diseases monitored for 24 hours. Protocol 3 included 22 patients admitted with electrical storm and monitored for 39.0 ± 28.2 hours. Protocol 4 included 3 patients who underwent bilateral stellate ganglion blockade with lidocaine injection.
RESULTS
In patients without heart diseases, spontaneous nerve discharges were frequently observed at baseline and were associated with heart rate acceleration. SKNA recorded from chest leads (V-V) during cold water pressor test and Valsalva maneuver (protocol 1) was invariably higher than during baseline and recovery periods (P < .001). In protocol 2, the average SKNA correlated with heart rate acceleration (r = 0.73 ± 0.14, P < .05) and shortening of QT interval (P < .001). Among 146 spontaneous ventricular tachycardia episodes recorded in 9 patients of protocol 3, 106 episodes (73%) were preceded by SKNA within 30 seconds of onset. Protocol 4 showed that bilateral stellate ganglia blockade by lidocaine inhibited SKNA.
CONCLUSION
SKNA is detectable using conventional ECG electrodes in humans and may be useful in estimating sympathetic tone.
背景
交感神经活动对心律失常的发生发展至关重要。
目的
本研究旨在开发一种使用传统心电图电极同时无创记录皮肤交感神经活动（SKNA）和心电图（ECG）的方法。该方法（neuECG）可用于充分评估交感神经张力。
方法
我们记录了56名人类受试者皮肤的neuECG信号。对信号进行低通滤波以显示心电图，进行高通滤波以显示神经活动。方案1包括12名健康志愿者，他们接受了冷水升压试验和瓦尔萨尔瓦动作。方案2包括19名癫痫住院患者，但无已知心脏病，进行了24小时监测。方案3包括22名因电风暴入院的患者，监测时间为39.0±28.2小时。方案4包括3名接受利多卡因注射双侧星状神经节阻滞的患者。
结果
在无心脏病的患者中，基线时经常观察到自发神经放电，并与心率加快相关。在冷水升压试验和瓦尔萨尔瓦动作（方案1）期间，从胸导联（V-V）记录的SKNA始终高于基线期和恢复期（P<.001）。在方案2中，平均SKNA与心率加快（r = 0.73±0.14，P<.05）和QT间期缩短（P<.001）相关。在方案3的9名患者记录的146次自发性室性心动过速发作中，106次发作（73%）在发作前30秒内有SKNA。方案4显示，利多卡因双侧星状神经节阻滞可抑制SKNA。
结论
在人类中使用传统心电图电极可检测到SKNA，其可能有助于评估交感神经张力。
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