心电散点图对房颤伴二度房室阻滞的诊断价值  

Diagnostic value of ECG scattergram in atrial fibrillation with second degree atrioventricular block

作　　者：王忠德[1] 刘培中[1] Wang zhongde;Liu peizhong(Guangdong Hospital of Traditional Chinese Medicine Zhuhai Branch,Zhuhai,519015,China)

机构地区：[1]广东省中医院珠海医院,519015

出　　处：《临床心电学杂志》2022年第1期37-41,共5页Journal of Clinical Electrocardiology

摘　　要：目的探讨24小时动态心电图和3D心电散点图、时间散点图诊断房颤伴二度房室阻滞的应用价值和效果。方法选择2016年9月至2019年12月在广东省中医院珠海医院治疗的心房颤动患者108例,根据患者是否伴有二度房室阻滞分为有二度房室阻滞的观察组(n=30)和无二度房室阻滞的对照组(n=78),两组患者入院后均完成24小时动态心电图检查,分析24小时动态心电图、3D心电散点图以及时间散点图诊断房颤伴二度房室阻滞的特征表现。结果24小时动态心电图结果表明:观察组平均心室率,少于对照组(p<0.05),观察组超过2秒的长RR期间平均数与对照组无明显差异(p>0.05);观察组的3D散点图具有明显特征,呈“甜筒状”,且从X-Y-Z观察呈类正六边形,两次圈选可估算二度房室阻滞的发生阵次,时间散点图可看出阻滞发生的时段;对照组的3D散点图呈近似三棱锥体的“陀螺形”或“花束形”,从X-Y-Z观察呈类三角形。结论24小时动态心电图能反映心房颤动患者心率变化,联合3D散点图、时间散点图能提高房颤伴二度房室阻滞的诊断效率和准确率,有较好的临床应用价值。Objective To explore the application value and effect of 24h Holter,3D Scattergram and Time scatter diagram in the diagnosis of atrial fibrillation with secondary atrioventricular block.Methods One hundred and eightpatients with atrial fibrillation who were treated in Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine from September 2016 to December 2019 were divided into observation group including patients with secondary atrioventricular block(n=30)and control group including patients without secondary atrioventricular block(n=78).Twenty-four-hour ambulatory electrocardiogram monitor was completed in both groups after admission.The characteristics of 24h ambulatory ECG,3D scattergram and time scatter diagram in the diagnosis of atrial fibrillation with secondary atrioventricular block were analyzed.Results The results of 24-hour ambulatory electrocardiogram showed that the average ventricular rate of the observation group was lower than that of the control group(p<0.05),and there was no significant difference between the observation group and the control group in the average of the long RR period over 2 seconds(p>0.05).The 3D scattergram of the observation group showed obvious characteristics of"sweet tube shape",and it shows like a regular heagon from the X-Y-Z observation.Two circles can be used to estimate the occurrence matrix of the secondary atrioventricular block,and the time scattergram can see the occurrence time of the block.The 3D scattergram was similar to the"top shape"or"bouquet shape"of the triangular body,and it was similar to a triangle when observed from X-Y-Z in the control group.Conclusions Twenty-four-hour ambulatory electrocardiogram can reflect the heart rate changes of patients with atrial fibrillation,and the combination of 3D scattergram and time scatter plot can improve the diagnostic efficiency and accuracy of atrial fibrillation with secondary atrioventricular block,which has better clinical application value.

关 键 词：24小时动态心电图 3D散点图 时间散点图 心房颤动 二度房室阻滞 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]