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[心律失常及症状的变异性——它们对长期心电图分析的影响]

[Variability of arrhythmias and symptoms--their effect on long-term ECG analysis].

作者信息

Weber H, Schmidinger H, Norman G, Rimpfl T, Wolfram J

机构信息

Kardiologischen Universitätsklinik Wien.

出版信息

Wien Med Wochenschr. 1988 Jan 31;138(1-2):12-8.

PMID:3354219
Abstract

The variability of variables influences conclusions in the measurement of biologic variables particularly if the variability of methodological variables are unidentified or of unknown range. Therefore prior the interpretation of Holter-results the interobserver variability of measured parameters (e. g. arrhythmias) and the system-dependent variables (e. g. reproducibility) have to be recognized. Measuring biologic variables like arrhythmias or symptoms using the Holter method the spontaneous variability of infrequent occurring phenomena has to be taken into account and also their relationship to the recording duration: Infrequent occurring phenomena demonstrate an enormous variability, which could be reduced by lengthening the recording duration beyond 24 hours, especially in the evaluation of an antiarrhythmic therapy to avoid a mimicked therapeutic effect. In symptomatic patients their symptoms can be related to arrhythmias or not if an ECG will be recorded during a typical symptomatic period. This depends on the frequency and on the duration of the symptoms, so that other methods than Holter-monitoring should be considered like event-recording, ECG-telephone-telemetry or electrophysiological investigations. In summary the variability of phenomena captured by the Holter method (e. g. arrhythmias, symptoms) is a major factor, which has to be taken into account to avoid unsatisfactorial use of the Holter method.

摘要

变量的变异性会影响生物学变量测量的结论,尤其是当方法学变量的变异性未被识别或范围未知时。因此,在解释动态心电图结果之前,必须认识到测量参数(如心律失常)的观察者间变异性和系统相关变量(如可重复性)。使用动态心电图方法测量心律失常或症状等生物学变量时,必须考虑罕见现象的自发变异性及其与记录时长的关系:罕见现象表现出巨大的变异性,通过将记录时长延长至24小时以上可降低这种变异性,尤其是在评估抗心律失常治疗时,以避免出现模拟的治疗效果。在有症状的患者中,如果在典型症状期记录心电图,其症状可能与心律失常有关,也可能无关。这取决于症状的频率和持续时间,因此应考虑采用动态心电图监测以外的其他方法,如事件记录、心电图电话遥测或电生理检查。总之,动态心电图方法所捕捉现象(如心律失常、症状)的变异性是一个主要因素,必须予以考虑,以避免对动态心电图方法的使用不当。

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