不同类型起搏器术后动态心电图的临床应用价值  

The clinical values of holter among different types of pacemaker postoperations

作　　者：欧阳征鹏[1] 李赵欢[1] 李霞[1] 

机构地区：[1]四川省医学科学院/四川省人民医院心功能科,成都610000

出　　处：《重庆医学》2015年第36期5082-5083,5086,共3页Chongqing medicine

基　　金：国家自然科学基金资助项目(81200135)

摘　　要：目的探讨动态心电图在不同类型起搏器术后的应用价值。方法选取该院2013年11月至2014年10月起搏器术后进行动态心电图检查的120例患者为研究对象,并分析感知、起搏功能异常以及起搏相关心律失常情况。结果 DDD型主要以室性期前收缩、房性期前收缩、短阵房速、短阵房颤、短阵室速为主,检出率分别为38.9%、44.4%、8.3%、2.8%、2.8%;DDD型起搏器感知和起搏功能异常以及起搏器相关心律失常检出率为69.4%,明显高于VVI型的42.5%、VVIR型的30.0%、DDDR型的31.3%、AAI型的25.0%,各型数据间比较差异有统计学意义(P<0.05)。VVI型以室性期前收缩、房性期前收缩、短阵房速、短阵房颤、短阵室速为主,检出率分别为37.5%、42.5%、10.0%、17.5%、2.5%;VVIR型主要以室性期前收缩、房性期前收缩、短阵房速为主,检出率分别为25.0%、25.0%、5.0%;DDDR型主要以室性期前收缩、房性期前收缩、短阵房速、短阵房颤为主,检出率分别为31.3%、25.0%、12.5%、12.5%;AAI型主要以室性期前收缩、房性期前收缩为主,检出率分别为25.0%、25.0%。结论临床应用动态心电图可以较好地了解不同类型起搏器工作状态,并监测起搏和起搏功能异常感知以及心律失常情况,应用价值高。Objective To explore the clinical values of holter among different types of pacemaker postoperations.MethodsSelected 120 patients undergoing pacemaker implantation from November 2013 to October 2014,who also received holter examination after operation.The sensing and pacing dysfunction and pacemaker associated arrhythmia were analyzed according to their holter results.Results In the DDD group,the detection rate of the ventricular premature contraction,the atrial premature contraction,the paroxysmal atrial tachycardia,the paroxysmal atrial fibrillation and the paroxysmal supraventricular tachycardia were 38.9%,44.4%,8.3%,2.8% and 2.8%,respectively.In the DDD group,the detection rate of the sensing and pacing dysfunction and pacemaker associated arrhythmia was 69.4%,which was significantly higher（P〈0.05）than that in the VVI group（42.5%）,the VVIR group（30.0%）,the DDDR group（31.3%）and the AAI group（25.0%）,respectively.In the VVI group,the positive rate of the ventricular premature contraction,the atrial premature contraction,the paroxysmal atrial tachycardia,the paroxysmal atrial fibrillation and the paroxysmal supraventricular tachycardia were 37.5%,42.5%,10.0%,17.5% and 2.5%,respectively.In the VVIR group,the appearance rate of the ventricular premature contraction,the atrial premature contraction and the paroxysmal atrial tachycardia were 25.0%,25.0% and 5.0%,respectively.In the DDDR group,the detectable rate of the ventricular premature contraction,the atrial premature contraction,the paroxysmal atrial tachycardia and the paroxysmal atrial fibrillation were 31.3%,25.0%,12.5% and 12.5%,respectively.Finally,in the AAI group,the detection rate of the ventricular premature contraction and the atrial premature contraction were 25.0% each.Conclusion The clinical application of holter can evaluate the working states of different types of pacemakers,and can monitor the sensing,the pacing dysfunction and the pacemaker associated arrhythmia.

关 键 词：起搏器 心电描记术 应用价值 

分 类 号：R654.2[医药卫生—外科学] R540.41[医药卫生—临床医学]