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[植入式心脏复律除颤器患者睡眠相关呼吸障碍的患病率。对恶性室性快速心律失常发生率和昼夜分布的影响]

[The prevalence of sleep-related breathing disorders in patients with implanted cardioverter-defibrillators. The effect on the incidence and circadian distribution of malignant ventricular tachyarrhythmias].

作者信息

Fries R, Heisel A, Bauer D, Fichter J, Jung J, Sybrecht G W, Schieffer H

机构信息

Abteilung Innere Medizin III, Universitätskliniken des Saarlandes, Homburg/Saar.

出版信息

Dtsch Med Wochenschr. 1996 Jun 7;121(23):747-51. doi: 10.1055/s-2008-1043064.

Abstract

OBJECTIVE

To determine the prevalence of sleep-related breathing disorders (SRBD) on patients who, because of malignant ventricular tachyarrhythmias associated with cardiac disease, have an implanted cardioverter-defibrillator (ICD). It was also investigated whether the frequency and circadian distribution of spontaneous ventricular tachycardia and (or) fibrillation (VTF) can be influenced by SRBD.

PATIENTS AND METHODS

29 consecutive ICD patients (28 men, one woman; mean age 64 +/- 8 years) were investigated by multifunction recordings. 22 patients had coronary heart disease, and seven dilated cardiomyopathy. For each patient the number of VIF episodes per month were recorded, as well as the percentage distribution of the episodes during the day per hour and after grouping into four time periods.

RESULTS

SRBDs were recorded in 13 of the 29 patients (45%) (apnoea-hypopnea index [AHI] > 10). The other 16 patients had normal findings (AHI < or = 10). Mean frequency of the registered VTF attacks was similar in both groups (0.41/month with AHI < or = 10 vs 0.44/month with AHI > 10; difference not statistically significant). Averaged percentage distribution pattern showed a maximum frequency in both groups between 6 o'clock and 12 o'clock a.m. There was no significant increase of VTF during the night (10 o'clock p.m.-6 o'clock a.m.) in the group with SRBD (19% with AHI > 10 vs 18.2% with ATF < or = 10; difference not significant).

CONCLUSION

There was a high prevalence of SRBD in the patients with ICD and underlying cardiac disease. No influence of SRBD on frequency and circadian distribution of VTF was demonstrated in patients with ICD during long-term observation.

摘要

目的

确定因与心脏病相关的恶性室性心律失常而植入心脏复律除颤器(ICD)的患者中睡眠相关呼吸障碍(SRBD)的患病率。同时研究SRBD是否会影响自发性室性心动过速和(或)颤动(VTF)的发作频率及时辰分布。

患者与方法

对29例连续的ICD患者(28例男性,1例女性;平均年龄64±8岁)进行多功能记录研究。22例患者患有冠心病,7例患有扩张型心肌病。记录每位患者每月的VIF发作次数,以及发作次数在白天每小时的百分比分布情况,并将其分为四个时间段进行分组。

结果

29例患者中有13例(45%)记录到SRBD(呼吸暂停低通气指数[AHI]>10)。另外16例患者检查结果正常(AHI≤10)。两组中记录到的VTF发作平均频率相似(AHI≤10组为0.41次/月,AHI>10组为0.44次/月;差异无统计学意义)。平均百分比分布模式显示两组在上午6点至12点之间发作频率最高。SRBD组在夜间(晚上10点至上午6点)VTF没有显著增加(AHI>10组为19%,AHI≤10组为18.2%;差异不显著)。

结论

ICD及潜在心脏病患者中SRBD的患病率较高。在长期观察中,未发现SRBD对ICD患者VTF的发作频率及时辰分布有影响。

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