心房颤动时高度或Ⅲ度房室阻滞的诊断  

The Diagnostic Problems of High or Third Degree Atrioventricular Block During Atrial Fibrillation

作　　者：刘德平[1] 乔巍巍[1] 董榕[1] 杨春英[1] 曾环宇[1] 

机构地区：[1]北京医院心内科

出　　处：《中国心脏起搏与心电生理杂志》1999年第1期32-34,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：为探讨心房颤动（简称房颤）时高度或Ⅲ度房室阻滞（ＡＶＢ）的诊断。分析房颤伴高度或Ⅲ度ＡＶＢ患者的２４ｈ动态心电图，测定持续性房颤者的平均心率（ＨＲ）、最大ＨＲ（ＨＲｍａｘ）、最小ＨＲ（ＨＲｍｉｎ）、最大ＲＲ间期（ＲＲｍａｘ）及阵发性房颤发作时的ＨＲｍａｘ、ＨＲｍｉｎ、ＲＲｍａｘ，并分析阵发性房颤转为窦性心律时有无ＡＶＢ发生及其程度。持续性房颤伴高度ＡＶＢ者（ｎ＝６４）平均ＨＲ７４．３±１０．３ｂｐｍ，日间ＨＲｍａｘ１３８．６±２７．２ｂｐｍ、ＨＲｍｉｎ４２．９±１０．６ｂｐｍ，夜间ＨＲｍａｘ１１８．８±２７．９ｂｐｍ、ＨＲｍｉｎ３６．３±６．０ｂｐｍ，ＲＲｍａｘ２．５８９±０．５２９ｓ。持续性房颤伴Ⅲ度ＡＶＢ者（ｎ＝１５）平均ＨＲ６５．５±１３．９ｂｐｍ，日间ＨＲｍａｘ１２１．９±３９．２ｂｐｍ、ＨＲｍｉｎ４０．１±８．４ｂｐｍ，夜间ＨＲｍａｘ９９．０±３２．３ｂｐｍ、ＨＲｍｉｎ３３．１±５．０ｂｐｍ，ＲＲｍａｘ２．４９２±０．６６１ｓ。阵发性房颤者（ｎ＝１０）房颤时ＨＲｍａｘ１５４．７±２３．５ｂｐｍ、ＨＲｍｉｎ４３．２±４．８ｂｐｍ、ＲＲｍａｘ１．９２３±０．５９７ｓ，在转为窦性心律时，仅４例伴有Ⅰ度Ａ?To investigate the diagnostic problems of high or third degree atrioventricular block(AVB) during atrial fibrillation(AF),24hour dynamic electrocardiogram with high or third degree AVB was analyzed and mean heart rate(HR),maximal HR(HRmax),minimal HR(HRmin),maximal RR interval (RRmax) were measured in patients with sustained AF and paroxysmal AF during AF.Whether AVB presented or not after terminating of AF in patients with paroxysmal AF and its degree were evaluated.Mean HR was 74.310.3 bpm,HRmax at day time 138.627.2 bpm,HRmax at night 118. 827.9 bpm,HRmin at day time 42.910.6 bpm,HRmin at night 36.36.0 bpm.RRmax 2.5890.529 s in patients with high degree AVB (n=64).65.513.9 bpm,121.939.2 bpm,99.032.3 bpm,40.18.4 bpm,33.15.0 bpm and 2.4920.66 s respectively in patients with third degree AVB (n=15).In patients with paroxysmal AF,HRmax was 154.723.5 bpm, HRmin 43.24.8 bpm,RRmax 1.9230.597 s,only 4 patients demonstrated first degree AVB after AF terminating.The result above suggests that much deeper research should be taken on the diagnosis of high or third degree AVB during AF.

关 键 词：心房颤动 房室阻滞 心电图 诊断 

分 类 号：R541.750.4[医药卫生—心血管疾病] R540.41[医药卫生—内科学]