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过速型室性心律失常(室速和室颤)是心脏猝死的一个主要诱因,有效的治疗手段是在体内置入埋藏式心脏复律除颤器.心脏复律除颤器能够准确、有效地捕捉到患者心律失常事件的发作并及时发放电击指令.本文采用两种基于熵的非线性复杂度测度——近似熵和样本熵,以及两种线性测度——平均RR间期(心电图相邻R波之间的时间间隔)和平均RR间期的标准差,分析了78名患者体内心脏复律除颤器中存储的135个室速或室颤事件刚刚发生前的一段RR间隔片段,并与来自同样患者的没有室性心律失常事件发生时(通常为窦性节律)记录到的RR间隔序列进行比较.结果显示,过速型室性心律失常发作前患者心跳会出现明显的加快现象,并且其心率变异性信号的近似熵和样本熵值均明显减小.室速或室颤事件发作前的一段时间内,患者自主神经系统中的交感神经张力增加,而其心率变异性信号的复杂度却降低了,表明心脏病患者过速型室性心律失常事件的自然发作并不是突发现象,而是在发作前的一段时间内就已经有了某种先兆.为了获得更好地识别室性心律失常事件的能力,单独分析了矢量匹配容差对两种算法性能的影响,从而确定了最佳的容差取值范围.因此,近似熵和样本熵测度有可能成为心脏复律除颤器中短时预测恶性过速型心律失常事件的有效的非线性参数.
Tachycardia and ventricular tachyarrhythmias (VT and VF) are a major cause of sudden cardiac death and an effective treatment is the introduction of an implantable cardioverter defibrillator in the body. Cardiac defibrillator can accurately and effectively Capture the onset of arrhythmia and timely release of electric shock instructions.In this paper, two kinds of entropy-based nonlinear complexity measures - approximate entropy and sample entropy, as well as two linear measures - the mean RR interval (ECG R Wave interval) and the standard deviation of the mean RR interval, an RR interval segment of 135 ventricular tachycardia or ventricular fibrillation events stored in 78 patients with cardioverter defibrillator immediately before the event was analyzed and compared with RR intervals recorded from the same patient in the absence of ventricular arrhythmias (usually sinus rhythm) were compared and the results showed a significant acceleration of the heartbeat in patients before the onset of tachyarrhythmia The approximate entropy of the heart rate variability signal and the sample entropy value were significantly decreased.The sympathetic tone in patients with autonomic nervous system increased during the period before VT or ventricular fibrillation and the heart rate The complexity of the opposite sex signal is reduced, indicating that spontaneous seizures of heart rate patients with tachyarrhythmia is not a sudden phenomenon, but rather a premonition some time before the episode. In order to obtain more The ability to identify ventricular arrhythmias well and analyze the effect of vector matching tolerance on the performance of the two algorithms separately to determine the optimal tolerance range.Therefore, approximate entropy and sample entropy measure may become the heart Effective non-linear parameters for short-term prediction of malignant tachyarrhythmias in cardioverter defibrillators.