The Ambulatory ECG-Based TWA Testing In Patients With Congestive Heartfailure

ObjectiveTo study the MTWA in patients with chronic heart failure under the resting state using the time domain of MMA techniques to provide heart failure patients with sudden death risk stratification based on simple laboratory; Provide the basis for the prognosis of patients with chronic heart failure, clinical medicine and for screening ICD implantation;Further confirmed the predictive value of the Ambulatory ECG-Based MMA TWA Testing of risk of sudden death in patients with chronic heart failure.MethodsAcquring the 24-hour ambulatory ECG in patients with chronic cardiac failure patients (EF<40%, n=40) and healthy peoples (n=76) by using the Holter,then MTWA test with time-domain analysis method of MMA(Modified moving average analysis) techniques was performed. Analyzed the difference of the MTWA of heart failure group and the healthy group; Analyzed of the MTWA correlation with cardiac function,which is accorded to NYHA classification of cardiac function in chronic heart failure were divided into two groups (â… /â…¡group andâ…¢/â…£group);Analyzed of the MTWA correlation with ejection fraction, which is divided into two groups(>35% and<35% Group);Analyzed the MTWA correlation with with cardiomyopathy which were divided into ischemic cardiomyopathy, dilated cardiomyopathy, peripartum cardiomyopathy;Analyzed the MTWA correlation with with the heart rate of chronic cardiac failure patients.Results1.The MTWA of Holter was significantly higher in CHF patients than healthy controls in the Average heart rate(AveRR),Maximum heart rate(TWA at peak HR)and 8am(TWA at 8AM) Average TWA (overall TWA)(P<0.05);however,there was no significant difference in Maximum MTWA (Max TWA)(P>0.05)2.The MTWA of Holter inâ… /â…¡group andâ…¢/â…£group was higher than the control group (P<0.05) in the average heart rate (AveRR), the Maximum heart rate (peak HR), mean TWA (overall TWA), however,there was no significant difference between the two groups (P> 0.05);the two groups at eight o'clock (8:00 am) was statistically significant (P <0.05)3.The MTWA of Holter in>35% and<35% group were higher than control group (P <0.05) in the average heart rate (AveRR), the Maximum heart rate (peak HR) and mean TWA (overall TWA), there is no significant difference between the two groups (P> 0.05);. The MTWA of Holter in (>35% groups)was higher than(<35% group) in 8:00am(P<0.05), however,there was no significant (P> 0.05);there is no significant difference between the two groups and the the healthy control group (P> 0.05) in Maximum MTWA (Max TWA), EF<35% group mean is higher than EF> 35% group4.The MTWA of Holter in Ischemic cardiomyopathy and dilated cardiomyopathy group were higher than the control group (P<0.05)in the average heart rate TWA (AveRR), the Maximum heart rate TWA (peak HR),8:00 TWA (8:00 am TWA)and the average of TWA (overall TWA),However,there was no significant difference between the two groups (P> 0.05);The MTWA of Holter was higher than the control group (P<0.05)in the Maximum heart rate and 8:00 TWA,however,there was no significant difference with ischemic cardiomyopathy and dilated cardiomyopathy, (P> 0.05);The MTWA of Holter in Peripartum cardiomyopathy group was lower than ischemic cardiomyopathy and dilated cardiomyopathy group in the average heart rate TWA (AveRR),the largest TWA (peak HR) and the mean TWA (overall TWA)(P<0.05),significantly different, but there was no significant difference the healthy control group (P> 0.05)Conclusions1.The MTWA was obtained though analyzing the 24-hour ambulatory ECG recorded used the Time-domain method is a promising approach for risk stratification for chronic cardiac failure patients2.The Sympathetic have influence on the Ambulatory ECG-based TWA testing in patients with congestive heart failure; The Heart rate have some influence on the MTWA,but it is Non-positive correlation;3.Cardiac function had no effect on the MTWA;It is may not improve the predictive value of malignant ventricular arrhythmia if we Associate with it;4.The EF have a certain impact on the Ambulatory ECG-based TWA testing in patients with congestive heart failure; It is may improve the prediction of malignant ventricular arrhythmia if we Associate with it; 5.Cardiomyopathy have some influence on the MTWA,It is may be better to provide the theoretical basis for Peripartum cardiomyopathy and prognosis and as a detection method to guide clinical treatment...