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早期复极受试者的室性及室上性异位搏动

Ventricular and Supraventricular Ectopy in Subjects With Early Repolarization.

作者信息

Trenkwalder Teresa, King Ryan, Kaess Bernhard M, Hengstenberg Christian, Schunkert Heribert, Ittermann Till, Felix Stephan B, Busch Mathias, Dörr Marcus, Reinhard Wibke

机构信息

Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany.

Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, Greifswald, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.

出版信息

Am J Cardiol. 2017 Jul 1;120(1):92-97. doi: 10.1016/j.amjcard.2017.03.254. Epub 2017 Apr 12.

Abstract

Early repolarization (ER) is a common electrocardiographic (ECG) finding that is associated with an increased risk of idiopathic ventricular fibrillation and sudden cardiac death. This study investigated whether the presence of ER is a predictor of ventricular and supraventricular ectopy as a marker for electrical instability. Standard 12-lead electrocardiograms of the first follow-up in the population-based Study of Health in Pomerania (SHIP-1) (n = 3,300, age 20 to 79 years) were analyzed to identify subjects with an ER pattern. Ventricular and supraventricular ectopy was assessed via portable tele-ECG cards recording 2 electrocardiograms daily over the course of 4 weeks. Data of 1,630 subjects (n = 83,833 ECG card recordings, average 51.4 per subject) were analyzed for ventricular and supraventricular ectopy using a standardized automated algorithm. Associations of ER and several forms of arrhythmias were assessed using a 2-sided Fisher's exact test or t test, where appropriate. Overall, prevalence of ER in the SHIP-1 population was 4.8%. Presence of ER was not associated with the occurrence of ventricular and supraventricular arrhythmias (p ≥0.05 for all analyses). Furthermore, subgroup analyzes for ER localization (inferior) and ST-segment morphology (horizontal/descending) did not show any association with arrhythmic events. In conclusion, presence of the ER pattern is not associated with an increased occurrence of ventricular or supraventricular arrhythmias as assessed by serial ECG card recordings in this large population-based sample.

摘要

早期复极(ER)是一种常见的心电图(ECG)表现,与特发性心室颤动和心源性猝死风险增加相关。本研究调查了ER的存在是否可作为心室和室上性早搏的预测指标,作为电不稳定的标志物。对基于人群的波美拉尼亚健康研究(SHIP-1)(n = 3300,年龄20至79岁)首次随访时的标准12导联心电图进行分析,以识别具有ER模式的受试者。通过便携式远程心电图卡评估心室和室上性早搏,该卡每天记录2份心电图,持续4周。使用标准化自动算法分析了1630名受试者(n = 83833份心电图卡记录,平均每位受试者51.4份)的心室和室上性早搏数据。在适当情况下,使用双侧Fisher精确检验或t检验评估ER与几种心律失常形式的关联。总体而言,SHIP-1人群中ER的患病率为4.8%。ER的存在与心室和室上性心律失常的发生无关(所有分析中p≥0.05)。此外,对ER定位(下壁)和ST段形态(水平/下降)的亚组分析未显示与心律失常事件有任何关联。总之,在这个基于人群的大样本中,通过连续心电图卡记录评估,ER模式的存在与心室或室上性心律失常发生率增加无关。

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