阵发性心房颤动伴心室长间歇的临床意义  

The clinical valuation of paroxysmal atrial fibrillation with ventricular long pause

作　　者：卢喜烈[1] 帅莉[1] 石亚君[1] 卢亦伟[2] 赵立朝[1] 陈光辉[1] 王曙[1] 

机构地区：[1]中国人民解放军总医院,100853 [2]北京航天中心医院,100039

出　　处：《临床心电学杂志》2006年第2期114-115,共2页Journal of Clinical Electrocardiology

摘　　要：目的了解阵发性心房颤动伴心室长间歇的临床意义。方法对动态心电图记录到的11例窦性心律伴阵发性心房颤动的患者伴发心室长间歇进行分析。男性10例,女性1例。年龄50～77(66.6±7.48)岁,特发性心房颤动6例,冠心病5例,脑梗塞1例。结果11例共发生特发性心房颤动570阵,大于2.0s的长间歇141次,长间歇在2.0～2.7s。时间分布为白天16次,夜间125次。心房颤动发作前后的窦性PR间期在0.15～0.20s之间者6例,一度房室阻滞3例,二度Ⅰ型房室阻滞1例。P波时限<0.11s的5例,≥0.11s的6例。24h最高心率77～175(126.5±23.2)bpm,最低心率35～47(42.2±2.92)bpm,平均心率53～90(68.6±11.12)bpm。结论阵发性心房颤动合并心室长间歇多出现于夜间睡眠时,心肌缺血、房内阻滞、房室阻滞等是其可能机制。Objective To investigate the clinical implication of paroxysmal atrial fibrillation with ventricular long pause. Methods 11 patients with paroxysmal atrial fibrillation and vehicular long parse were analyzed, including 10 men and 1 woman with mean age of 66.6 ± 7.48（50-70） years old. Results 6 patients had idiopathic atrial fibrillation, 5 patients had coronary artery disease and one had brain infarction. There were totally 570 episodes of atrial fibrillation in all patients. Among them 141 episodes had a RR interval longer than 2.0s （range 2.0-2.7s）, 16 occurred at day times while 125 at night. Sinus PR interval before or after atrial fibrillation were 0.15s-0.20s in 6 cases. First degree atrioventricular block was diagnosed in 3 cases and second degree atrioventricular block in one case. P wave duration was shorter than 0.10s in 5 cases and ≥0.11s in 6 cases. The maximum heart rate is 126.5±23.2（77-175） bpm, the minimum heart rate 12 （53-90） bpm. Conclusion Paroxysmal atrial during sleeping at night, myocardial iachemia, probable causes. is 42.2±2.92（35-47） bpm and the average is 68.6±11. fibrillation with ventricular long pause usually occured intratrial block and atfioventricular block may be the probable causes.

关 键 词：阵发性心房颤动 心室长间歇 动态心电图 

分 类 号：R541.75[医药卫生—心血管疾病]