The Relationship Between The Coupling Interval Of Premature Beat And Hemodynamics

Background and ObjectivePremature beat (beat extrasystole) is one of the most frequent cardiac arrhythmia in clinical cardiovascular diseases such as coronary heart disease, rheumatic heart disease, hypertensive heart disease, pulmonary heart disease, myocardial disease, myocarditis and so on. Also see in the other illness of Systemic disease and health adults. It shows that 30%-50% normal healthy adult have premature beat In 24 hours ambulatory electrocardiogram. The age is more old the premature beat are more frequency and complicated. It were be pay close attention to the reasons of premature beat, mechanism, organic heart disease risk of dying suddenly, however,it were be pay less attention to the study of the relationship between the coupling interval of premature beat and hemodynamics. The study choosed patients who with spantaneous premature beat that was confirmed by twelve-lead surface electrocardiograms or patients with artificial artrial premature beat that were induced by the technique of transesophageal artrial pacing test. Cardiac function was investigated by cardiac function check apparatus. The pulsographic areas were caculated by signal processing technique. Effect of PB on hemodynamics was analyzed statistically.Materials and Methods1 From july 2005 to September 2006,fouty-eight patients(eighteen left APB and thirty right APB )with artrial premature beat (APB), fifty- patients(twenty-one left VPB and thirty right VPB )with ventricular premature beat (VPB), thirty patients (ninety examples) with artrial premature beat that were induced by the technique of transesophageal artrial pacing test were detected by twelve-lead surface electrocardiograms. Sixty-four were male and sixty-five were female, aged 58±2.9y. There were fouty-six patients with coronary artery disease combine with hypertension and hypertensive heart disease, thirty -three patients with hypertension and hypertensive heart disease, twenty -nine patients with hypertension,twenty -one others. Chosen the premature patients without interoposition, conjugate and coupled rhythm, atrial fibrillation with VPB.2 The advanced ratios of premature beat:(normal cardiac cycle-the coupling interval of premature beat)/normal cardiac cycle, the advanced ratios of artrial premature beat= (PP-PP ' ) /PP; the advanced ratios of ventricular premature beat= (RR-RR') /RR. According to the advanced ratios, the premature beats were divided into three groups, >40% 20%-40% <20% of the advanced ratios.3 The location of premature beat: P ' upside down on I avL lead, straighten on avR are left artrial premature beats, P ' straighten on I avL lead, upside down on avR are right artrial premature beats; QRS wave to offer right bundle branch block are left ventricular premature beat, QRS wave to offer left bundle branch block are right ventricular premature beat. According to premature beat location, The premature beats were divided into four groups, 18 patients with left artrial premature beats, 30 patients with right artrial premature beats, 21 patients with left ventricular premature beats, 30 patients with right ventricular premature beats.4 Thirty patiens who identified etiological factor of supraventricular tachycar were investigated by CF-4 cardiac function check apparatus. APBs were induced by the technique of transesophageal artrial pacing test. Selected the pulsographics which premature beats advanced ratios were >40%, 20%-40%and<20%.5 189 examples with premature beats were investigated through cardiac function check apparatus. And the pulsographics of PB, the first sinus beats before PB and the first sinus beat after PB were kept.Among them,there were forty-eight with artrial premature beat and fifty-one with ventricular premature beat of pulsographics and thirty patients (ninety examples) with artrial premature beat that were induced by the technique of transesophageal artrial pacing test of pulsographics were kept there times according to>40% 20%-40% <20% of the advanced ratios.6 To calculate the effect of premature beat on hemodynamics indirectly,the pulsographics areas of PB,the first sinus beats before PB and the first sinus beat after PB were measured by signal processing technique. Results1 When advanced ratios were same, there was a negative correlation between spontaneous and artificial APB of pulsographic areas (P<0.05); and a positive correlation between APB and VPB (P> 0.05).2 The pulsographic areas of spontaneous APB and VPB were smallest when the advanced ratios were >40%,which were middle when the ratios were between 20%-40%, and largest when the ratios were <20%. There were significantly different among three groups (P<0.05) .3 When advanced ratios of APB were same, there was a negative correlation between left and right artrial of pulsographic areas (P>0.05).4 When advanced ratios of VPB were same, there was a. positive correlation between left and right ventricular (P<0.05 ) .5 The pulsographic areas of APB and VPB were smallest,which were middle when the first sinus beats before PB were appeared, and were largest when the first sinus beats after PB were present. There were significantly different among three groups (P< 0.05) .Conclusions1 There was positive correlation of the coupling interval of PB on hemodynamics. The coupling interval was more shorter, the pulsographic areas of PB corresponding of the coupling interval was more smaller,the effect on hemodynamics was more larger.2 There was no correlation between effects of APB on hemodynamics and the sites of APB . There was a negative correlation effects on hemodynamics between left and right artrial of APB.3 There was positive correlation between the coupling interval and the sites of VPB on hemodynamics. The effect of left VPB on hemodynamics was larger than that of right VPB on hemodynamics.4 Although PBs have compensatory intervals, the compensation of stroke volume is no completely.