不同特殊功能起搏器的时间散点图特征及意义  

Characteristics and significance of time-RR scatterplot of cardiac pacemaker with different special functions

作　　者：张芳芳[1] 李世锋[1] 潘运萍[1] 李中健[1] Zhang Fang-fang;Li Shi-feng;Pan Yun-ping;Li Zhong-jian(Department of Electrocardiogram,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450014,China)

机构地区：[1]郑州大学第二附属医院心电图科,河南郑州450014

出　　处：《实用心电学杂志》2018年第1期33-37,共5页Journal of Practical Electrocardiology

基　　金：2018年度河南省重点研发与推广专项科技攻关项目资助

摘　　要：目的观察不同特殊功能起搏动态心电图时间散点图的形态特征,并据此判断起搏器特殊功能。方法对128例植入起搏器患者的动态心电图进行回顾性分析,按起搏器特殊功能类别分为四组:无特殊功能组(A组)、频率滞后功能组(B组)、病态窦房结综合征患者或心房颤动伴VVI起搏器开启频率适应功能组(C组)和睡眠功能组(D组)。观察各组时间散点图的形态特征。结果 (1)四组共同特点:(1)当24 h完全为起搏心律时,时间散点图为较窄致密的"线状";(2)当24 h为部分起搏时,时间散点图上缘有明显"界线",而"界线"位于RR间期≤1.2 s区间内,下缘呈"点状或云雾状"的条形图。(2)四组不同特点:A组时间散点图为一条直线或"界线";B组时间散点图分为三层,中间层致密,上层为一条直线,下层为一条有起伏变化的散点;C组时间散点图为一条有高低变化但无变化规律的线或"界线";D组时间散点图白天为"直线状",夜间表现为"梯形状"。结论不同特殊功能起搏器具有不同的动态心电图时间散点图形态特征,依据其特征可快速判断起搏器特殊功能,为基层医护人员快速、准确判断起搏器特殊功能提供了新方法及依据。Objective To determine the special functions of cardiac pacemaker by observing the morphological characteristics of its time-RR scatterplot.Methods A total of 128 patients implanted with pacemakers were classified into four groups according to special functions of cardiac pacemakers:group A(without special function),group B(frequency lagging behind function),group C(with sick sinus syndrome or atrial fibrillation complicating VVI pacemaker s frequency adapting to function)and group D(with sleeping function).The morphological characteristics of time-RR scatterplot were observed in each group.Results Patients in the four groups shared the following features:(ⅰ)when pacing rhythm covered 24 hours,time-RR scatterplot appeared as narrow and compact“line”;(ⅱ)when pacing rhythm partly covered 24 hours,an obvious“boundary line”below 1.2 s showed at the upper edge of time-RR scatterplot while the lower edge formed a“punctate or cloudlike”bar chart.The time-RR scatterplot of each group had its own characteristics:in group A,it was a straight line or“boundary line”;in group B,it was separated into three layer-compact middle layer,straight linear upper layer and lower layer with fluctuating scatter belt;in group C,it was a line or“boundary line”varying in height and disobeying any changing law;in group D,it appeared as a straight line in the day while it was“ladder-shaped”at night.Conclusion The morphological characteristics of time-RR scatterplot vary among pacemakers with different special functions and the characteristics help to make quick judgment of pacemaker s special functions.It provides a new method and reference for primary medical staffs to judge the special functions of pacemakers quickly and accurately.

关 键 词：特殊功能 起搏器 动态心电图 时间散点图 

分 类 号：R540.41[医药卫生—心血管疾病]