动态心电图长RR间期的临床分析  

Clinical analysis of long RR interval in ambulatory electrocardiography

作　　者：曾德芳[1] 李佳骏[1] 陈红梅[1] 

机构地区：[1]成都市第五人民医院心电图室,四川成都611130

出　　处：《实用心电学杂志》2017年第5期320-324,共5页Journal of Practical Electrocardiology

摘　　要：目的探讨动态心电图长RR间期的临床价值。方法对205例非持续性房颤患者动态心电图RR≥2 000 ms者进行回顾性分析,统计导致长间期的各类病因及心电图改变。结果205例患者中50岁以上者占83.50%,病因以冠心病、高血压、糖尿病、心肌梗死多见。出现长RR间期的心电图改变主要为房性早搏未下传24.88%(51/205),房性早搏3.90%(8/205),室性早搏5.36%(11/205),窦性停搏12.69%(26/205),二度窦房阻滞12.20%(25/205),房速、房颤或房扑终止16.10%(33/205),窦性心动过缓伴不齐9.27%(19/205),阵发性室上速或室速、室扑终止3.41%(7/205),高度房室阻滞5.85%(12/205),二度房室阻滞18.05%(37/205),三度房室阻滞3.41%(7/205),起搏器感知或起搏功能异常3.41%(7/205)。最长RR间期达75.32 s。结论动态心电图是检测长RR间期的一种安全有效的方法。分析导致长RR间期的原因并结合临床症状,对抗心律失常药物的使用、安装起搏器及评价起搏器功能等有重要指导意义。Objective To investigate the clinical value of long RR interval in ambulatory electrocardiography（ AECG）. Methods Retrospective analysis was carried out on 205 patients with non-persistent atrial fibrillation whose RR interval≥2 000 ms in AECG. We recorded and counted various causes of disease resulting in long RR interval and ECG changes. Results Among the 205 patients,people over 50 years old accounted for 83. 50%,and the common causes of disease included coronary artery disease,hypertension,and myocardial infarction. Long RR interval mainly appeared in the following ECG changes： blocked atrial premature beats accounting for 24. 88%（ 51/205）; atrial premature beats accounting for 3. 90%（ 8/205）; ventricular premature beats accounting for 5. 36%（ 11/205）; sinus arrest accounting for 12. 69%（ 26/205）; second degree sino-atrial block accounting for 12. 20%（ 25/205）; the termination of atrial tachycardia,atrial fibrillation or atrial flutter accounting for 16. 10%（ 33/205）; sinus bradycardia complicating sinus arrhythmia accounting for 9. 27%（ 19/205）; the termination of paroxysmal supraventricular tachycardia,or ventricular tachycardia and ventricular flutter accounting for 3. 41%（ 7/205）; high degree artrioventricular block accounting for 5. 85%（ 12/205）; second degree atrioventricular block accounting for 18. 05%（ 37/205）; third degree atrioventricular block accounting for 3. 41%（ 7/205）; abnormalities in percep-tive and pacing function of pacemaker accounting for 3. 41%（ 7/205）. The longest RR interval was75. 32 s. Conclusion AECG proves to be a safe and effective method to measure long RR intervals.It is significantly instructive for taking anti-arrhythmic drugs,installing pacemakers and evaluating pacemaker’s function to analyze the reasons for long RR interval and clinical symptoms.

关 键 词：非持续性房颤 动态心电图 长RR间期 临床价值 

分 类 号：R540.41[医药卫生—心血管疾病]