Lee Jiann-Der, Kuo Ya-Wen, Lee Chuan-Pin, Huang Yen-Chu, Lee Meng, Lee Tsong-Hai
Department of Neurology, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan.
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
J Clin Med. 2023 Jan 29;12(3):1050. doi: 10.3390/jcm12031050.
To evaluate the association between the visit-to-visit heart rate variability and the risk of atrial fibrillation (AF) in acute ischemic stroke (AIS).
We analyzed the data of 8179 patients with AIS. Patients without AF on 12-lead electrocardiography underwent further 24 h Holter monitoring. They were categorized into four subgroups according to the visit-to-visit heart rate variability expressed as the coefficient of variation in heart rate (HR-CV). Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using the HR-CV < 0.08 subgroup as a reference.
The adjusted OR of paroxysmal AF was 1.866 (95% CI = 1.205-2.889) for the HR-CV ≥ 0.08 and <0.10 subgroup, 1.889 (95% CI = 1.174-3.038) for the HR-CV ≥ 0.10 and <0.12 subgroup, and 5.564 (95% CI = 3.847-8.047) for the HR-CV ≥ 0.12 subgroup. The adjusted OR of persistent AF was 2.425 (95% CI = 1.921-3.062) for the HR-CV ≥ 0.08 and <0.10 subgroup, 4.312 (95% CI = 3.415-5.446) for the HR-CV ≥ 0.10 and <0.12 subgroup, and 5.651 (95% CI = 4.586-6.964) for the HR-CV ≥ 0.12 subgroup.
HR-CV can facilitate the identification of patients with AIS at a high risk of paroxysmal AF.
评估急性缺血性卒中（AIS）患者就诊间心率变异性与房颤（AF）风险之间的关联。
我们分析了8179例AIS患者的数据。12导联心电图显示无房颤的患者进一步接受24小时动态心电图监测。根据以心率变异系数（HR-CV）表示的就诊间心率变异性，将他们分为四个亚组。以HR-CV<0.08亚组作为参照，估算比值比（OR）和95%置信区间（CI）。
HR-CV≥0.08且<0.10亚组阵发性房颤的校正OR为1.866（95%CI=1.205-2.889），HR-CV≥0.10且<0.12亚组为1.889（95%CI=1.174-3.038），HR-CV≥0.12亚组为5.564（95%CI=3.847-8.047）。HR-CV≥0.08且<0.10亚组持续性房颤的校正OR为2.425（95%CI=1.921-3.062），HR-CV≥0.10且<0.12亚组为4.312（95%CI=3.415-5.446），HR-CV≥0.12亚组为5.651（95%CI=4.586-6.964）。
HR-CV有助于识别阵发性房颤高危的AIS患者。
