运动试验早期心率快速增加与室性心律失常的关系

Association of rapid increased heart rate at onset of treadmill exercise test and ventricular arrhythmia

目的探讨心电图平板运动试验早期心率的快速增加与室性心律失常及心肌缺血的关系。方法选择245例进行了心电图平板运动试验与冠状动脉造影的胸痛患者，根据运动试验开始后第1分钟心率的增加量（△HR1minute）分为心率快速增加组（AHR1minute≥12次／min）154例与心率增加正常组（AHR㈨。。〈12次／min）91例，对比分析2组在运动试验中室性心律失常的发生率及运动试验、冠脉造影阳性率。结果心率快速增加组在运动试验中严重室性心律失常的发生率显著高于心率增加正常组（P〈0．01）；心率快速增加组运动试验及冠脉造影阳性率均显著高于心率增加正常组（P〈0．05，P〈0．01）。结论运动试验早期心率快速增加可反映心肌缺血，并易诱发严重室性心律失常。

Objective To investigate the association of rapid increased heart rate at onset of treadmill exercise test and ventricular arrhythmia and myocardial ischemia. Methods 245 subjects who underwent electrocardiogram treadmill exercise test and coronary angiography were divided into rapid increased heart rate group and normal increased heart rate group according to the increased heart rate during the first minute （ AHR1minute ） of treadmill exercise test. The rate of ventricular arrhythmias during treadmill exercise test and the positive rates of treadmill exercise test and coronary angiography were analyzed. Results The rate of serious ventricular arrhythmias during treadmill exercise test in the rapid increased heart rate group was significantly higher than that in the normal increased heart rate group（ P 〈 0. 01 ）. The posi- tive rates of treadmill exercise test and coronary angiography in the rapid increased heart rate group were significantly higher than those in the normal increased heart rate group（ P 〈 0. 05, P 〈 0. 01 ）. Conclusion The rapid increased heart rate during the first minute of treadmill exercise test can reflect myocardial ischemia and easily induce serious ventricular arrhythmia.