24小時心電圖Holter針對21位曾暈倒過的病人檢測,發現平日心跳過低(Sick Sinus Syndrome;低於每分鐘50下)的人偶而也會心跳過速; 平日常有心室提前收縮(Ventricular Premature Beats)心律不整的一種) 但心跳速率正常的人偶而也會心跳過低或心跳過速;HRV分析對病情了解很有幫助
Electrophy siologic noninvasives parameters in patients with sick sinus syndrome and syncopal attacks.
Rom J Intern Med. 1994; 32(2):143-52 (ISSN: 1220-4749)
Nicolin M; Dr?gulescu SI; Petrescu LP
Medical-Surgical Cardiologic Center Timi?oara, First Medical Clinic, Romania.
21 patients accusing previous syncopal attacks, without myocardial infarction, preexcitation syndrome or severe cardiac failure were submitted to a 24 hrs Holter monitoring with 10 min. of esophageal electrocardiogram. Nine patients were considered as cases of sinus bradycardia (mean HR = 49.5 +/- 4.4 b/min). Other 12 patients with normal basic sinus rhythm were admitted for ventricular premature beats (HR = 65.5 +/- 8.7 b/min.). Fourier transformation analysis (mean method, linear interpolation) was used for determination of the heart rate variability (HRV) and other two variables: variation range (VR)--(longest-shortest cycle/mean basic sinus cycle, %) and differences of sinus cycle length (DSCL = maximal difference of any two consecutive sinus cycle, ms). In all the 9 patients with low sinus rhythm and in 7 patients with normal basic sinus rhythm, at least one episode of critical bradycardia (under 45 b/m) was observed. In 3 of the 9 patients with sinus bradycardia at least two episodes of nonsustained ventricular tachycardia were observed. In all the 12 patients with ventricular premature beats, many episodes of nonsustained ventricular tachycardia were registered. In all the 21 studied patients low and very low frequency HRV was observed. The VR and DSCL presented a significant dependence on age, but this relationship was weaker than the established limits of normality. In the cases of sick sinus syndrome with sinus bradycardia and/or severe ventricular tachyarrhythmias, the noninvasive Holter analysis of HRV can determine the correct diagnosis and indications for permanent cardiac pacing and antiarrhythmic drug therapy