老年冠心病患者室性心动过速发作的时辰节律

Circadian variation of ventricular tachycardia in elderly patients with coronary heart disease

以５０例老年人和３０例非老年人动态心电图监测２４小时内室性心动过速发作≥１次、且未行抗心律失常药物治疗的住院患者为对象，比较分析了老年冠心病患者室性心动过速发作的时辰分布特征。发现老年冠心病患者室性心动过速发作在２４小时内围绕９：５９呈单峰分布（ｒ＝０．２６２４９，Ｐ＜０．０２），与心性猝死时辰分布特征相似；而非老年组室性心动过速发作呈现两个高峰，第一个高峰位于６：００～９：００，第二个高峰位于１８：００～２１：００。二者之间的不同尚待进一步研究。

Abstract The diurnal distribution of ventricular tachycardia (VT) in patients hospitalized because of heart diseases was analyzed. Eighty consecutive patients not taking antiarrhythmic drugs with VT more than once on Holter electrocardiographic monitoring were studied. Fifty elderly patients (age≥60, range 60-82) had coronary heart disease (group A) and 30 younger patients (age<60, range 14-57) had coronary heart disease, rheumatic heart disease or cardiomyopathy (group B). There were 132 VTs (mean 1.65 VTs/patient, range 1 to 6) in the 80 patients: 67 in group A (mean 1.34 VTs/patient, range 1 to 4) and 65 in group B (mean 2.17 VTs/patient, range 1 to 6). A significant circadian rhythm in the frequency of VT existed in both groups. The peak incidence was between 5 and 13 in group A. This pattern is similar to that reported for acute myocardial infarction, sudden cardiac death and transient myocardial ischemia.The hourly VT frequency in group B showed two peaks: one in the early morning 6-9 and the other in the late afternoon, 18-21.The cause of the difference of circadian rhythm of VT between the two groups is unknown. Further studies are needed.