Clinical Study Of MTWA And HRV In The Amplitude Of Early Cardiac Repolarization

ObjectiveThe purpose of this study was to observe microvolt T-wave alternation(Microvolt T-wave alternans,MTWA)and heart rate variability(Heart Rate Variabilit,HRV)to study and analyze early repolarization waves(Early repolarization wave,ERW)with different amplitudes of patients with Early cardiac repolarization by 24-hour dynamic electrocardiogram(Holter),investigating the long-term predictive value of MTWA and HRV for sudden cardiac death and malignant ventricular arrhythmia in these patients.MethodsIn this study,80 patients with ERW on ECG were randomly selected from Liaocheng People’s Hospital from 2016 to 2018 as the study group.According to the amplitude of ERW,patients were divided into group I(0.1mv < J wave amplitude < 0.2mv)and group II(J wave amplitude < 0.2mv).80 healthy people with normal ECG were randomly selected as control group.The 24-hour ambulatory electrocardiogram was analyzed by modified moving average(modified moving average,MMA)technique in time domain nalysis to obtain MTWA,HRV related indicators and occurrence of ventricular arrhythmias in all patients,and to make a comparative analysis.Results1.Contrast comparison of general data:There was no significant difference in age,sex and 24-hour average heart rate between study group and control group and between group I and group II(P > 0.05).2.Comparison of MTWA in each group:The average value of three channels Max TWA in the study group was higher than that in the control group(P < 0.05);the average value of three channels Max TWA in the group II was higher than that in the group I(P < 0.05).3.Comparison of HRV in each group:Compared with the control group,HRV time domain indexes SDNN,SDANN,RMSSD and PNN50 in the study group were significantly higher(P < 0.05),while frequency domain indexes LF,HF and LF/HF in the study group were significantly lower(P < 0.05),and VLF had no significant difference(P > 0.05).Compared with group I,time domain index SDNN,RMSSD and PNN50 in the group II were significantly higher(P < 0.05),SDANN had no significant difference(P >0.05),while frequency domain index HF and LF / HF in the group II decreased significantly(P < 0.05),but there was no significant difference in VLF and LF(P > 0.05).4.Comparison of ventricular premature beats in each group:The average number of premature ventricular contractions within 24 hours in the study group was significantly higher than that in the control group(P < 0.05),and the average number of premature ventricular contractions within 24 hours in the group II was significantly higher than that in the I group(P < 0.05).Conclusion1.MTWA and HRV can be used as important indicators for risk stratification of malignant cardiac events in patients with early cardiac repolarization.2.With the increase of J wave amplitude,the number of premature ventricular beats in patients with premature repolarization increased,inferred the risk of ventricular arrhythmia events increased.3.Through the analysis of MTWA and HRV,health education and long-term follow-up should be increased for patients with high risk of malignant arrhythmia,and clinical intervention should be carried out necessarily.