Diagnostic capacity of sinus node recovery time after inhibition of autonomous neural tone.

European journal of cardiology Pub Date : 1980-01-01
H Vallin, O Edhag, E Sowton
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Abstract

Symptomatic arrhythmias often occur intermittently in patients with sinus node dysfunction. A diagnostic test with ability to reveal latent sinus disease has therefore been much sought for. Determinations of sinus node recovery time (SNRT) and corrected sinus node recovery time (CSNRT) have been attempted but limitations in their diagnostic power are well recognized. To eliminate a possible masking effect of autonomous neural tone, propranolol 0.1 mg/kg and atropine 0.02 mg/kg was administered to 30 patients with established symptomatic sinus bradydysrhythmias (SSBD) and to a control group of 18 age-matched healthy volunteers. In addition the same procedure was applied to 9 patients with symptoms suggesting SSBD in whom, however, this cause was later excluded. The upper normal limit of CSNRT defined by the control group was 545 msec before and 505 msec after drugs. In the SSBD group, CSNRT was falsely negative in 8 of the 30 patients. Repeated testing after drug inhibition reduced this number to 2 patients. Thus, the sensitivity increased from 73% to 93%. CSNRT determinations were normal in the non-SSBD patients, specificity remaining at 100%. Thus, the discriminative power of electrophysiologic testing for sinus node disease was found to be high when CSNRT determinations were performed both before and after drug inhibition of autonomous neural tone.

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自主神经张力抑制后窦结恢复时间的诊断能力。
窦房结功能障碍患者常间歇性出现症状性心律失常。因此,一种能够显示潜伏性鼻窦疾病的诊断试验一直被广泛寻求。已尝试测定窦结恢复时间(SNRT)和矫正窦结恢复时间(CSNRT),但其诊断能力的局限性是公认的。为了消除自主神经张力可能的掩盖效应,对30例已确定症状性窦性慢性心律失常(SSBD)患者和18名年龄匹配的健康志愿者给予0.1 mg/kg的心得安和0.02 mg/kg的阿托品。此外,同样的程序应用于9例有SSBD症状的患者,但后来排除了这一原因。对照组规定的CSNRT正常上限值为用药前545 msec,用药后505 msec。在SSBD组中,30例患者中有8例CSNRT假阴性。药物抑制后的重复测试将这一数字减少到2例。因此,灵敏度从73%提高到93%。CSNRT检测在非ssbd患者中正常,特异性保持在100%。因此,在药物抑制自主神经张力之前和之后进行CSNRT测定时,发现电生理测试对窦结疾病的判别能力很高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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