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盐酸索他洛尔治疗对阵发性心房颤动患者心房信号平均心电图的影响

[The effect of sotalol hydrochloride therapy on atrial signal-averaged ECG in patients with paroxysmal atrial fibrillation].

作者信息

Telichowski A, Banasiak W, Wiech K, Zeborowski J, Pieróg M, Ponikowski P, Kałka D, Lacheta W, Fuglewicz A, Telichowski C

机构信息

Klinika Chorób Wewnetrznych Wojskowego Szpitala Klinicznego we Wrocławiu.

出版信息

Pol Merkur Lekarski. 1996 Nov;1(5):303-9.

PMID:9273201
Abstract

The aim of this study was to evaluate of oral sotalol hydrochloride effects on atrial signal-averaged ECG (ASAECG) during time- and frequency-domain analysis in patients with paroxysmal atrial fibrillation (PAF) during ischemic heart disease (IHD). The study population of 27 was composed of 16 female and 11 male, mean age 56.1 +/- 8.4. The dose of oral sotalol was 160 mg/day for all days. Recording of ASAECG and 24-hours Holter monitoring were made at baseline, after 10 days and after 6 weeks of sotalol therapy. For ASAECG were calculated time-domain parameters: the root mean square voltage of the signals in the last 10, 20, 30 ms of the filtered P-wave (RMS 10, 20, 30) and total time duration of filtered P-wave (PWD) and time duration of P-wave for Frank leads X, Y, Z (XP, YP, ZP). During frequency-domain analysis of the terminal part of P-wave we calculated the following parameters in range from 40 Hz to 400 Hz: energy spectrum > -60 dB (A) and decibel drop at 40 Hz (Dd) in logarithmic scale and area ratio 20-50/0-20 Hz (Ar), magnitude ratio (MR1-7) in linear scale for a vector magnitude. Supraventriculat arrhythmias were estimated quantitatively and qualitatively during Holter monitoring. The following parameters were estimated in a case of PAF recording: time of manifestation, duration, number of PAF episodes per day, mean heart rate during PAF and subjective symptoms. Moreover, comparable analysis of the following parameters: dimension of left atrial, age, gender, time duration of IHD and PAF and wall motion disturbances-hypokinesis and also left ventricular ejection fraction, mitral regurgitation was done between patients with effective and no effective of antiarrhythmic therapy. Our observation have indicated that oral sotalol therapy are responsible for statistically significant decrease of total time duration of filtered P-wave (PWD) and time duration of P-wave for Frank leads X, Y, Z (XP, YP, ZP) and increase area ratio 20-50/0-20 Hz in patients with PAF during IHD. Moreover, comparable analysis of above-mentioned parameters have not showed statistically significant differences between examined patients with effective and lack of effective sotalol therapy.

摘要

本研究的目的是评估口服盐酸索他洛尔对缺血性心脏病(IHD)合并阵发性心房颤动(PAF)患者在时域和频域分析期间心房信号平均心电图(ASAECG)的影响。研究人群共27例,其中女性16例,男性11例,平均年龄56.1±8.4岁。所有患者口服索他洛尔的剂量均为160mg/天。在基线、索他洛尔治疗10天后和6周后进行ASAECG记录和24小时动态心电图监测。对于ASAECG,计算时域参数:滤波后P波最后10、20、30ms信号的均方根电压(RMS 10、20、30)、滤波后P波的总时长(PWD)以及Frank导联X、Y、Z的P波时长(XP、YP、ZP)。在P波终末部分的频域分析中,我们在40Hz至400Hz范围内计算以下参数:能量谱> -60dB(A)、40Hz时以对数标度表示的分贝下降(Dd)以及20 - 50/0 - 20Hz的面积比(Ar)、向量幅值的线性标度下的幅值比(MR1 - 7)。在动态心电图监测期间对室上性心律失常进行定量和定性评估。在记录PAF的情况下评估以下参数:发作时间、持续时间、每日PAF发作次数、PAF期间的平均心率以及主观症状。此外,对有效和无效抗心律失常治疗患者的以下参数进行了对比分析:左心房大小、年龄、性别、IHD和PAF的持续时间以及室壁运动障碍 - 运动减弱,还有左心室射血分数、二尖瓣反流。我们的观察表明,口服索他洛尔治疗可使IHD合并PAF患者的滤波后P波总时长(PWD)以及Frank导联X、Y、Z的P波时长(XP、YP、ZP)在统计学上显著缩短,并使20 - 50/0 - 20Hz的面积比增加。此外,上述参数的对比分析在索他洛尔治疗有效和无效的患者之间未显示出统计学上的显著差异。

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