Zhang Yuan, Wang Jing, Xu Yonggang
ECG Room, Liaocheng People's Hospital, Liaocheng, China.
Bachelor of Medicine, Department of Cardiology, Liaocheng People's Hospital, Liaocheng, China.
Ann Palliat Med. 2020 Sep;9(5):3488-3494. doi: 10.21037/apm-20-1362.
Ventricular fibrillation (VF) is the main cause of sudden death in Acute myocardial infarction (AMI) patients. Identifying arrhythmia as early as possible is of great significance in improving prognosis of AMI patients. The article is aimed at exploring the predictive value of heart rate variability (HRV) of dynamic electrocardiogram (DCG) in VF of elderly AMI patients.
A total of 122 elderly AMI patients were enrolled as the research objects. They were divided into VF group and simple AMI group (AMI group). All underwent DCG test after admission. The basic data of patients were compared. HRV of DCG was observed. The predictive value of HRV of DCG in VF of elderly AMI patients was evaluated by receiver operating characteristic (ROC) curves.
The ratio of Killip at grade II-III, activity of creatine kinase-MB (CK-MB), standard deviation of all R-R intervals (SDNN), the standard deviation of the R-R intervals (SDANN), root-mean-square of the successive differences of normal RR intervals (rMSSD) and percentage of NN50 in the total number of NN intervals PNN50 (PNN50%)]in VF group were higher than those in AMI group (P<0.05). The area under the ROC curves (AUC)and cut-off values of SDNN, SDANN, rMSSD and PNN50% were (0.773, 0.761, 0.800, 0.819) and (135.675, 106.850, 33.570, 14.080), respectively.
HRV of DCG is of certain predictive value for VF in the elderly with AMI, which is expected to be an auxiliary diagnosis method of VF.
心室颤动（VF）是急性心肌梗死（AMI）患者猝死的主要原因。尽早识别心律失常对改善AMI患者的预后具有重要意义。本文旨在探讨动态心电图（DCG）心率变异性（HRV）对老年AMI患者VF的预测价值。
选取122例老年AMI患者作为研究对象。将其分为VF组和单纯AMI组（AMI组）。所有患者入院后均接受DCG检查。比较患者的基本资料。观察DCG的HRV。采用受试者工作特征（ROC）曲线评估DCG的HRV对老年AMI患者VF的预测价值。
VF组Killip分级II - III级的比例、肌酸激酶同工酶（CK - MB）活性、所有R - R间期标准差（SDNN）、R - R间期标准差（SDANN）、正常RR间期连续差值的均方根（rMSSD）以及NN50在NN间期总数中所占百分比（PNN50%）均高于AMI组（P<0.05）。ROC曲线下面积（AUC）以及SDNN、SDANN、rMSSD和PNN50%的截断值分别为（0.773，0.761，0.800，0.819）和（135.675，106.850，33.570，14.080）。
DCG的HRV对老年AMI患者的VF具有一定的预测价值，有望成为VF的辅助诊断方法。
