时间散点图诊断心房颤动伴Ⅱ度房室传导阻滞的探讨  

The Diagnostic Exploration in Patients of Persistent Atrial Fibrillation With II° Atrial-Ventricular Block by t-RR Plot of Ambulatory Electrocardiogram

作　　者：张芳芳[1] 刘儒[1] 王永生[1] 潘运萍[1] 李世锋[1] 李中健[1] 

机构地区：[1]郑州大学第二附属医院心电图科,河南省450014

出　　处：《中国循环杂志》2013年第5期342-344,共3页Chinese Circulation Journal

摘　　要：目的：通过回顾性分析持续性心房颤动（房颤）患者24小时动态心电图（AECG）时间散点图，寻找简单、直观、快速诊断心房颤动伴Ⅱ度房室传导阻滞的依据。方法：回顾性分析10900例AECG中340例明确诊断为持续性房颤患者，根据诊断结果分为单纯持续性房颤组（A组，n=280）、持续房颤伴Ⅱ度房室传导阻滞组（B组，n=20）、持续性房颤＋心室起搏组（C组，n=40）。结果：①A组时间散点图条带增宽，上缘呈“云雾状”，下缘呈有界限的“带状或波浪状”；②B组时间散点图有明显上界，“界线”位于RR间期1．5～1．8s区间内，下缘呈“点状或云雾状”；③C组时间散点图有明显上界，而“界线”位于RR间期〈1．2s区间内，下缘呈“云雾状”；④三组比较，形态特征：B组时间散点图有明显上界，且“界线”位于RR间期1．5—1．8s区间内；年龄比较：C组平均年龄高于B组，B组高于A组。结论：AECG时间散点图有明显上界，且“界线”位于RR间期1．5～1．8s区间内的特征性改变，可以作为持续房颤伴Ⅱ度房室传导阻滞诊断的依据。Objective： To find a simple, intuitive and fleet method for diagnosing the persistent atrial fibrillation （AF） with Ⅱ° atrial- ventricular block （AVB） by t-RR plot of ambulatory electrocardiogram （AECG）. Methods： We retrospectively studied 340 of 10 900 AF patients with persistent AF, according to t-RR plot of AECG, they were divided into 3 groups, simple persistent AF （Group A, n=280）, persistent AF with Ⅱ°AVB （Group B, n=20） and persistent AF ＋ ventricular pacemaker （Group C, n=40）. Results： ① In Group A, t-RR plot stripe was wide and the upper limb looked like thin cloud. The lower limb showed limited stripe or wave. ② In Group B, t-RR plot had obvious upper limb and the boundary located between RR 1.5-1.8s. The lower limb was like spots or cloud. ③ In Croup C, the upper limb of t-RR plot was similar to Group B, the boundary located within RR 1.2s. The lower limb was cloudy. ④ Compared among 3 groups, in morphology, Group B had obvious upper limb of t-RR plot and the boundary between RR 1.5-1.8s; in mean age, Croup C〉Group B〉Group A. Conclusion： The patients having obvious upper limb of t-RR plot in AECG with the boundary between RR 1.5-1.8s could be considered as the evidence for diagnosing the persistent AF with Ⅱ° AVB.

关 键 词：心房颤动 Ⅱ度房室传导阻滞 动态心电图 时间散点图 

分 类 号：R541[医药卫生—心血管疾病]