单导联心电图记录系统进行心房颤动机会性筛查的首个国内经验  

Pioneering experience of single-lead electrocardiogram for opportunistic screening for atrial fibrillation in China

作　　者：苏晞[1] 张劲林[1] 韩宏伟[1] 唐成[1] 杨新玮 江晶晶[1] 刘颖[1] 刘智双 王凡 李静[1] 

机构地区：[1]武汉亚洲心脏病医院心内科,430022

出　　处：《中华心律失常学杂志》2017年第6期485-488,共4页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的 心房颤动（房颤）是临床常见的心律失常,开展房颤筛查、合理使用抗凝药物是减少房颤相关脑卒中的重要举措.本研究旨在评价AliveCor手持单导联心电图记录系统诊断房颤的准确性,并分析在医院及诊所开展房颤机会性筛查的人群特征.方法 自2017年5月27日至6月15日,武汉亚洲心脏病医院工作人员同时于武汉市2个社区门诊、武汉亚洲心脏病医院门诊应用AliveCor手持单导联心电图记录系统进行房颤机会性筛查.记录所有被筛查者的年龄、性别,对房颤筛查阳性者记录临床相关病史.结果 共1742人接受AliveCor筛查,年龄18～89（61.4±12.7）岁.新筛查房颤患者106例,平均年龄（68.8±9.7）岁,显著高于阴性筛查者（60.8±12.8）岁,差异具有统计学意义（P〈0.01）.AliveCor手持单导联心电图记录系统正确识别所有房颤患者.65岁以上新筛房颤患者中CHA2 DS2-VASc评分≥2分者占71％.结论 AliveCor手持单导联心电图记录系统诊断房颤便捷、高效、准确,可用于大规模人群的房颤筛查.65岁以上人群新筛查房颤阳性率高,且脑卒中风险评分高,在该组人群进行房颤筛查可能具有更大的社会经济获益.Objective Atrial fibrillation（AF） is a common dysrhythmia with wide variety of presentations. Screening of AF and appropriate usage of oral anticoagulants are important measures in preventing AF related stroke. The current observational study is to evaluate the accuracy of single-lead electrocardiogram（ ECG） in diagnosis of AF and describe features of people receiving opportunistic screening for AF in hospital and in clinics. Methods Between May 27th ,2017 and June 15th ,2017,we do opportunistic screening for AF in two clinics and in Wuhan Asian Heart Hospital with AliveCor hand-held single-lead ECG.Ages and gender of all screening persons were recorded as well as past medical history in positive screening patients. Results A total of 1742 persons received AF screening, 106 of them were diagnosed with new AF.The average age of new AF patients was（68. 8±9. 7） years,significantly older than that of negative screening patients[（60. 8±12. 8） years,P〈0. 01].All AF rhythm was correctly identified by automated algorithm.Seventy-one percents of new AF patients were over 65-year-old and had a CHA2 DS2-VASc score greater than 2 points. Conclusions AliveCor single-lead ECG is an easy,efficient,and accurate method for diagnosis of AF.This device can be applied for screening AF in large-scale population.A higher prevalence of new AF and a higher risk score for stroke in patients over 65 years of age may have greater socioeconomic benefits in screening for atrial fibrillation in this cohort.

关 键 词：心房颤动 单导联心电图 筛查 

分 类 号：R541.75[医药卫生—心血管疾病]