老年患者严重缓慢性心律失常74例临床分析  

Clinical analysis of 74 elderly patients with severe bradyarrhythmia

作　　者：陆江辉[1] 冯燕娴[1] 李玉杰[1] 张隽[1] 李晶晶[1] 桑更生[1] 

机构地区：[1]安徽省蚌埠市第三人民医院心内科,233000

出　　处：《蚌埠医学院学报》2008年第1期59-60,共2页Journal of Bengbu Medical College

摘　　要：目的:探讨老年患者严重缓慢性心律失常的临床特征。方法:对74例老年严重缓慢性心律失常患者的临床资料和心电图、动态和静态心电记录、心律失常的类型和治疗方法进行分析。结果:首发晕厥32例,黑矇17例,头晕15例;病态窦房结综合征39例,高度房室传导阻滞26例,心房颤动伴长RR间歇9例;超过3 s的长RR间期35例;心率在白天清醒状态下持续<40次/分31例。全部给予安置永久性心脏起搏器治疗,部分患者给予抗心律失常药物治疗。结论:严重性缓慢性心律失常可引起老年患者症状加重;常规心电检查可以明确患者的心率和心律变化,明确晕厥的原因,便于临床合理选择治疗方法,永久性心脏起搏器是有效的方法。Objective： To study the clinical features of severe bradyarrhythmias in elderly patients. Methods： The clinical data, electrocardiogram,static and dynamic electrocardiogram, classification of arrhythmia and therapy of 74 elderly patients with severe bradyarrhythmias were retrospectively analyzed. Results：Of the 74 cases, 39 cases presented sick sinus syndrom,26 cases （35.14%） high degree atrioventricular block and 9 cases atrial fibrillation with long RR interval. Syncope occurred in 32 cases, near syncope in 17 cases and dizziness in 15 cases. Thirty-five cases were observed 〉 3 seconds long RR intervals by dynamic and static electrocardiogram and 31 cases had a heart rate of 〈 40 times/minute on daytime. Parmanent cardiac pacing therapy was applied to all the cases and some patients received antiarrhythmial therapy. Conclusions ： Severe bradyarrhythmias usually leads to severe symptoms in elderly patients. Static and dynamic electrocardiogram is of great value in distinguishing the cause of syncope and obtaining the change of heart rate and rhythm, Parmanent cardiac pacing combined with antiarrhythmial therapy is efficient in treatment of bradycardia with tachyarrhyarrhythmias.

关 键 词：心律失常 晕厥 病态窦房结综合征 心脏传导阻滞 心房纤颤 心脏起搏 老年病学 

分 类 号：R541.7[医药卫生—心血管疾病] R544.2[医药卫生—内科学]