| BackgroundEarly repolarization pattern(early repolarization pattern/variant,ERP/ERV)refers to the presence of early repolarization wave(ERW)or J wave in electrocardiogram(EEG),which is a phenomenon of electrocardiogram abnormality.It has been an important number of the arrhythmia family.Once,ERP has always been considered a normal physiological ECG changes,and patients always with good prognosis,they do not need drugs and other treatment.Until recently,some studies and case reports have been found that it was associated with sudden cardiac death and idiopathic ventricular tachycardia/ventricular fibrillation,which may be related to the underlying mechanisms of action that lead to this change in electrocardiogram.So we have doubts about whether it is benign.A higher incidence of early repolarization in the crowd,but the real risk of sudden death or a small number of people,which can identify early high-risk and low-risk groups is essential The relationship between early repolarization and ventricular arrhythmia and sudden cardiac death is still controversial.In the past,a large number of studies have shown that there is a close relationship between T wave alternans and ventricular arrhythmia,and it is considered as a noninvasive electrophysiological test index with predictive value for malignant arrhythmia.Heart rate variability,as a noninvasive quantitative analysis method,mainly used to assess the heart of the autonomic nervous system regulation.The potential mechanism of early repolarization may be related to the change of T wave and the change of heart rate variability.Therefore,this study is to understand the characteristics of T wave alternation and heart rate variability in early repolarization in order to provide the foundation for the later studiesObjectiveTo investigate the changes of the relevant indicators of microvolt T-wave alternans(MTWA)and heart rate variability(HRV)in patients with ERP under 24-hour dynamic electrocardiogram(DCG/Holter),so as to further explore the occurrence of ventricular arrhythmia in patients with ERPMethodsA total of ninety patients were examined by standard 12-lead electrocardiogram in the presence of early repolarization.There were thirty cases of early repolarization only in the anterolateral wall(group ?),only in the inferior wall were thirty cases(group ?),thirty cases of extensive distribution(group ?)existed in both the anterolateral wall and the inferior wall,and the medical staff who had normal physical examination and excluded other cardiovascular diseases were healthy control group(Group ?)thirty cases.The changes of microvolt T wave alternans index and 24-hour heart rate variability and the incidence of ventricular arrhythmia were measured by dynamic electrocardiogram modified moving average(MMA)in the early repolarization group and the healthy control group.Research results1.There were no significant differences in age,gender,twenty four hours of average heart rate and other clinical data between the groups ?,?,?,?,the difference was not statistically significant.(P>0.05).2.Microvolt T wave alternans index:the each channel of MaxTWA of group ? was higher than group ?,the difference was statistically significant(P<0.05);the each channel of MaxTWA value of group ? was higher than that of group ?,the difference was statistically significant(P<0.05);the each channel of MaxTWA value of group ? is higher than that in group ?,the difference was statistically significant(P<0.05);the each channel of maxTWA value of group ? was higher than the value of the first group,the difference was statistically significant(P<0.05);the each channel of maxTWA value of group ? was higher than that of group ?,the difference was statistically significant(P<0.05);the each channel of maxTWA value of group ? was higher than that of group ?,the difference was statistically significant(P<0.05).3.Heart rate variability index:?comparison of time domain indexes:there was no significant difference between group ? and group ?(P>0.05);group ? was higher than that in group ?,the difference was statistically significant(P<0.05);group ? was higher than that in group ?,the difference was statistically significant(P<0.05);group ? was higher than that of group ?,there was significant differences(P<0.05);group ? was higher than that in group ?,the difference was statistically significant(P<0.05).?The frequency domain index comparison:group ? was lower than that of group ?,there was no statistically significant difference(P>0.05);group ? is lower than that of group IV,the difference was statistically significant(P<0.05);group ? is lower than in group ?,the difference was statistically significant(P<0.05);group ? was lower than that in group ?,the difference was statistically significant(P<0.05);group ? was lower than that in group?,the difference was statistically significant(P<0.05);group ? is lower than the first group,the difference was not statistically(P>0.05).4.Comparison of 24 hours of ventricular premature beats:ventricular premature beat in group ? was more than that in group ?,the difference was statistically significant(P<0.05);group ? was more than in group ?,thsignificant e difference was statistically significant(P<0.05);group ? was higher than that in group ?,the difference was statistically significant(P<0.05);group ? was more than in group ?,the difference was statistically significant(P<0.05);group ? was more than in group ?,the difference was statistically significant(P<0.05);group ? was more than that in group ?,the difference was statistically significant(P<0.05)Research conclusionThe Max TWA value is related with the level of early repolarization wave in lead MaxTWA value of the distribution of wide lead was the largest,there are decreases in the inferior wall and only appear in the anterolateral wall,but both were higher than the normal control group;early repolarization with wide lead,the indexes of heart rate variability significantly abnormal,appear in the inferior wall to be slightly second,the index of heart rate variability in the anterolateral wall had no significant difference with normal control group;type ? of early repolarization patients with arrhythmia may be higher than the possibility of type ? and type ?,we should attach great importance and follow-up actively.Changes of MTWA and HRV detection may be used as reference for risk stratification in patients with early repolarization. |
PDF Full Text Request