Curtis M J, Walker M J
Cardiovascular Research, Rayne Institute, St Thomas' Hospital, London.
Cardiovasc Res. 1988 Sep;22(9):656-65. doi: 10.1093/cvr/22.9.656.
Arrhythmia scores have been used in recent years to facilitate the analysis of arrhythmias, particularly in relation to regional myocardial ischaemia. The recent Lambeth Conventions recommended caution in the use of arrhythmia scores since their use may be misleading. In the present study seven scoring systems were examined in an attempt to validate the use of arrhythmia scores. A strong positive correlation was present between all seven scores. Furthermore, the scores all correlated with the incidences of ventricular fibrillation, ventricular tachycardia, and ventricular premature beats in early myocardial ischaemia. All seven scores successfully detected statistically significant reductions in the incidence of ventricular fibrillation resulting from the administration of two drugs. Some of the scores occasionally showed statistically significant reductions when effects on the raw arrhythmia data were not statistically significant. In this respect, parametric statistical analysis of arrhythmia scores may be a more sensitive method of quantifying arrhythmias than non-parametric analysis of binomially distributed raw data such as the incidence of ventricular fibrillation (in accordance with the power of such tests) indicating that the scores have precision. However, none of the scores incorrectly showed a statistically significant reduction when the raw data expressed a statistically significant or non-significant increase, indicating that the scores have accuracy. In conclusion, it is possible to design many arrhythmia scores that show changes in arrhythmia severity when more conventional analyses show only non-statistically significant trends. When used in conjunction with raw arrhythmia data, comprehensive drug dose ranges, and appropriate parametric statistical tests, arrhythmia scores facilitate the quantification of arrhythmias. It is recommended that arrhythmia scores should be used only for quantifying group data and model building and not for prognostic purposes in individuals.
近年来，心律失常评分已被用于促进心律失常的分析，特别是与局部心肌缺血相关的分析。最近的兰贝斯会议建议在使用心律失常评分时要谨慎，因为其使用可能会产生误导。在本研究中，对七种评分系统进行了检查，以试图验证心律失常评分的使用。所有七种评分之间都存在强正相关。此外，这些评分均与早期心肌缺血时室颤、室性心动过速和室性早搏的发生率相关。所有七种评分都成功检测到了两种药物给药后室颤发生率的统计学显著降低。当对原始心律失常数据的影响无统计学显著性时，一些评分偶尔也显示出统计学显著降低。在这方面，心律失常评分的参数统计分析可能是一种比二项分布原始数据（如室颤发生率）的非参数分析更敏感的量化心律失常的方法（根据此类测试的效能），这表明评分具有精确性。然而，当原始数据显示统计学显著增加或无显著增加时，没有一个评分错误地显示出统计学显著降低，这表明评分具有准确性。总之，当更传统的分析仅显示非统计学显著趋势时，有可能设计出许多能显示心律失常严重程度变化的心律失常评分。当与原始心律失常数据、综合药物剂量范围和适当的参数统计测试结合使用时，心律失常评分有助于心律失常的量化。建议心律失常评分仅用于量化组数据和模型构建，而不用于个体的预后目的。
