贴附式长程动态心电监测在心血管专科门诊患者中的应用价值  

Application value of long-term continuous electrocardiogram monitoring in cardiovascular outpatients

作　　者：何佳[1] 刘俊[2] 黄建凤[1] 贾玉和[1,2] He Jia;Liu Jun;Huang Jianfeng;Jia Yuhe(Center of Cardiac Function,Fuwai Hospital,State Key Laboratory of Cardiovascular Disease,National Center for Cairdiovascular Diseases,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100037,China;Center of Arrhythmia,Fuwai Hospital,State Key Laboratory of Cardiovascular Disease,National Center for Cairdiovascular Diseases,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100037,China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心心血管疾病国家重点实验室阜外医院功能检测中心,100037 [2]中国医学科学院北京协和医学院国家心血管病中心心血管疾病国家重点实验室阜外医院心律失常中心,100037

出　　处：《中华心律失常学杂志》2021年第2期132-136,共5页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的探讨门诊患者采用单导联贴附式长程心电记录仪进行心律失常事件心电监测的价值。方法回顾性分析2019年1月至2020年1月在中国医学科学院阜外医院门诊接受连续7 d长程心电监测患者的病史与心电监测资料。严重心律失常事件包含频发房性早搏、长段房性心动过速、心房颤动、频发室性早搏、持续性室性心动过速、RR间期>3 s等。结果377例患者完成7 d长程心电监测,其中47例(12.5%,47/377)既往有不明原因晕厥发作。长程心电监测持续总时间147(134,157)h,有效心搏总数52.7万(43.6万,60.9万)个。最长RR间期1.6(1.4,1.9)s,其中85例(22.6%,85/377)患者RR间期>2 s,20例(5.3%,20/377)患者RR间期>3 s,最长RR间期13.2 s。心律失常事件分析:窦性心律失常41例(10.9%,41/377),房室传导阻滞和逸搏31例(8.2%,31/377),房性心律失常336例(89.1%,336/377),室性心律失常233例(61.8%,233/377)。既往无心律失常病史的225例患者中211例(93.8%,211/225)新发现心律失常事件,其中窦性心律失常14例(6.6%,14/211),房室传导阻滞和逸搏18例(8.5%,18/211),房性心律失常194例(91.9%,194/211),室性心律失常132例(62.6%,132/211)。190例(50.4%,190/377)出现严重心律失常,而新发现心律失常患者中85例(40.3%,85/211)出现严重心律失常。47例晕厥病史患者中19例(40.4%,19/47)有严重心律失常事件发生。结论持续长程心电监测有助于门诊患者筛查出严重心律失常事件和寻找不明原因晕厥的病因。Objective To investigate the cardiac arrhythmia events which continuously recorded by a single lead attached electrocardiogram(ECG)recorder for long-term(7-day)in outpatients.Methods A retrospective analysis was performed on the medical history and ECG monitoring data of patients who received 7 consecutive days of long-term ECG monitoring in the outpatient department of Fuwai Hospital from January 2019 to January 2020.Severe arrhythmia events included frequent premature atrial contraction(PAC),long atrial tachycardia(AT),atrial fibrillation(AF),frequent premature ventricular contraction(PVC),sustained ventricular tachycardia(SVT),RR interval>3 seconds,and so on.Results Three hundred and seventy-seven patients completed 7 days of continuous long-term ECG monitoring,of which 47(12.5%,47/377)had a history of unexplained syncope.The total duration of long-term ECG monitoring was 147(134,157)h,and the total number of effective cardiac beats was 527 thousand(436 thousand,609 thousand).The longest RR interval was 1.6(1.4,1.9)s,of which 85(22.6%,85/377)were RR interval>2 s,20 cases(5.3%,20/377)RR interval>3 s,the longest RR interval 13.2 s.Analysis of arrhythmia events:41 cases(10.9%,41/377)of sinus arrhythmia,31 cases(8.2%,31/377)of atrioventricular block and escape stroke,336 cases(89.1%,336/377)of atrial arrhythmia,and 233 cases(61.8%.233/377)of ventricular arrhythmia.Among the 225 patients who with no previous history of arrhythmia,211(93.8%,211/225)patients were newly found arrhythmia events,including 14 cases(6.6%,14/211)of sinus arrhythmia,18 cases(8.5%,18/211)of atrioventricular block and arrhythmia,194 cases of(91.9%,194/211)atrial arrhythmia,and 132 cases(62.6%,132/211)of ventricular arrhythmia.Severe arrhythmia occurred in 190(50.4%,190/377)patients and in 85(40.3%,85/211)of the newly identified arrhythmias.Severe arrhythmia events occurred in 19(40.4%)of the 47 patients with a history of syncope.Conclusion Continuous long-term ECG monitoring is helpful for outpatients screening for severe arrhythmia events an

关 键 词：心律失常 心性 长程心电监测 晕厥 门诊患者 

分 类 号：R541.7[医药卫生—心血管疾病]