先天性心脏病经导管封堵术前后心律失常的变化  

Observation of arrhythmia before and after transcatheter closure of congenital heart disease

作　　者：张志辉[1] 宋治远[1] 庄国强[1] 孙玉锦[1] 史光鉴[1] 陈莉[1] 

机构地区：[1]第三军医大学西南医院心血管内科重庆市介入心脏病学研究所,重庆400038

出　　处：《重庆医学》2006年第3期205-206,共2页Chongqing medicine

基　　金：西南医院临床研究专项基金资助项目(SW2004017)

摘　　要：目的通过观察先心病经导管封堵术前后心律失常的变化,探讨经导管封堵术后新发心律失常的类型及对患者预后的影响。方法选择在我院成功进行封堵术治疗的房间隔缺损、室间隔缺损(VSD)及动脉导管未闭患者133例进行研究,分别于封堵术前1d及术后第4天记录12导联同步心电图及24h动态心电图,由电脑自动分析并经心电专业人员进行校正。结果133例中60例(45.1%)于术前检测出70例次不同的心律失常,其中偶发性早搏及不完全性右束支传导阻滞72.9%。心房颤动及Lown′s 4级以上室性早搏仅占12.9%。封堵术后新发心律失常38例(28.6%),其中VSD封堵术后心律失常发生率最高、且较严重,包括1例间歇性Ⅲ度房室传导阻滞伴晕厥患者。结论先心病经导管封堵术后近1/3的患者可发生新的心律失常,其中VSD封堵术后心律失常的发生率最高、且较严重。Objective To summarize the change of arrhythmia before and after transcatheter closure of congenital heart disease, and to discuss the effects of arrhythmia on prognosis. Methods One hundred and thirty-three cases accepting successful transcatheter closure were analyzed, including patients with patent ductus arteriosus, atrial septal defect and ventricular septal defeet（VSD）. Twelve leads ECG and 24h record of Holter were taken at ld before and 4d after transeatheter closure. The results were automatically analyzed by computer and then corrected by professional electrocardiogram technician. Results Seventy times of different kinds of arrhythmia were detected in 60 cases, in which 72. 9% were occasional premature contraction and incompletely right bundle branch block, Atrial fibrillation and severe premature ventricular contraction accounted for 12. 9 %. Thirty-eight cases （28.6 %） of new arrhythmia were found after transcatheter closure. Arrhythrnia of post- closure was more frequent and severe in VSD patients, including 1 case of intermittent Ⅲ° atrioventrieular block. Conclusion New arrhythmia occurs in about one-third patients after transcatheter closure. Arrhythmia in VSD patients is more frequent and severe after transeatheter closure.

关 键 词：先天性心脏病 经导管封堵术 心律失常 

分 类 号：R541.1[医药卫生—心血管疾病] R815[医药卫生—内科学]