Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America; Department of Internal Medicine, University of Palermo, Italy.
Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States of America.
Int J Cardiol. 2021 Aug 15;337:64-70. doi: 10.1016/j.ijcard.2021.05.006. Epub 2021 May 6.
Prolonged monitoring of cardiac rhythm has been used to screen for subclinical atrial fibrillation (AF); little is known about other arrhythmias in the general population, especially in the elderly, who are at higher risk of arrhythmias.
We evaluated the frequency of arrhythmias in the tri-ethnic (white, Black, Hispanic), community-based Subclinical Atrial Fibrillation and Risk of Ischemic Stroke (SAFARIS) study using a patch-based recorder for up to 14 days in 527 participants free of AF, congestive heart failure (CHF) or history of stroke. Differences according to gender, age, ethnicity and presence of hypertension, diabetes and pertinent ECG and echocardiographic variables were examined.
Mean age was 77.2 ± 6.8 years (37.2% men, 62.8% women). AF was present in 10 participants (1.9%), only 2 of them symptomatic. Supraventricular tachycardia (SVT) and ventricular tachycardia (VT) episodes were observed in 84.4% and 25.0% but only 13.5% and 10.6% of participants reported symptoms, respectively. Severe bradycardia (<40 bpm) was present in 12.5%. Sinus pauses and high-degree atrioventricular blocks were infrequent (2.1% and 1.5%, respectively). Most arrhythmias were more frequent in participants > 75 years; ventricular arrhythmias and severe bradycardia were more common in men. Whites had significantly more episodes of AF than Hispanics, SVT than Blacks and VT ≥ 10 beats than Hispanics and Blacks. Hypertensives had more episodes of severe bradycardia. LV hypertrophy or LVEF <55% were associated with more frequent ventricular and supraventricular arrhythmias.
Prolonged cardiac rhythm monitoring revealed moderate frequency of AF, but higher than expected frequencies of AF-predisposing arrhythmias. Ventricular arrhythmias were relatively frequent, whereas severe bradyarrhythmias were infrequent.
长时间监测心脏节律已被用于筛查亚临床心房颤动（AF）；对于一般人群中的其他心律失常知之甚少，尤其是在心律失常风险较高的老年人中。
我们使用基于补丁的记录仪在无 AF、充血性心力衰竭（CHF）或中风史的 527 名参与者中评估了三民族（白种人、黑种人、西班牙裔）社区亚临床心房颤动和缺血性中风风险（SAFARIS）研究中的心律失常频率，最长监测时间为 14 天。根据性别、年龄、种族以及高血压、糖尿病和相关心电图和超声心动图变量的存在情况，检查了差异。
平均年龄为 77.2 ± 6.8 岁（37.2%为男性，62.8%为女性）。10 名参与者（1.9%）存在 AF，其中仅 2 名有症状。观察到室上性心动过速（SVT）和室性心动过速（VT）发作分别为 84.4%和 25.0%，但仅有 13.5%和 10.6%的参与者报告有症状。严重心动过缓（<40 bpm）的发生率为 12.5%。窦性停搏和高度房室传导阻滞较为少见（分别为 2.1%和 1.5%）。大多数心律失常在>75 岁的参与者中更为常见；男性的室性心律失常和严重心动过缓更为常见。与西班牙裔人相比，白人的 AF 发作次数更多，SVT 发作次数多于黑人，VT 发作次数大于 10 次的患者比西班牙裔人和黑人更常见。高血压患者的严重心动过缓发作次数更多。LV 肥厚或 LVEF<55%与更频繁的室上性和室性心律失常相关。
长时间心脏节律监测显示出中度频率的 AF，但 AF 倾向的心律失常的频率高于预期。室性心律失常相对频繁，而严重的缓慢性心律失常则很少见。
