十二导联穿戴式心电设备院前诊断室上性心动过速的回顾性研究  被引量:3

Retrospective study on pre-hospital diagnosis of supraventricular tachycardia with 12-lead Wearable electrocardiogram devices

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作  者:王泓森 陈韬[2] 颜勇[2] 时向民[2] 石亚君[2] 陈韵岱[2] 郭军[2] Wang Hongsen;Chen Tao;Yan Yong(Medical School of Chinese PLA,Beijing 100853,China)

机构地区:[1]解放军医学院,北京100853 [2]解放军总医院第六医学中心心血管学部

出  处:《中华保健医学杂志》2022年第2期87-90,共4页Chinese Journal of Health Care and Medicine

基  金:国家重点研发计划(2018YFC2001205)。

摘  要:目的探索十二导联穿戴式心电设备对于室上性心动过速(supraventricular tachycardia,SVT)院前诊断的应用价值。方法选取2017年4月~2021年8月使用十二导联可穿戴式心电设备后诊断为室上性心动过速的356例患者,根据穿戴式心电图初步辨别SVT机制为房室结折返性心动过速(atrioventricular nodal reentrant tachycardia,AVNRT)或房室折返性心动过速(atrioventricular reentrant tachycardia,AVRT),并分为AVNRT组与AVRT组,对两组患者的简要主诉及心电图特征运用T检验、秩和检验等方法进行回顾性分析。结果十二导联穿戴式心电设备对于室上性心动过速的自动诊断模型准确率为98.43%。由患者上传心电图至评估用时为113(77~175)s,评估至审核用时为73.5(32~143.25)s。应用场景分为医院诊所(69/104,66.35%)、家中记录(30/104,28.85%)、工作单位(3/104,2.88%)、行车途中(1/104,0.96%)与户外路边(1/104,0.96%)。描记时间点分为发作后立即记录(31/104,29.81%)、发作后10~30 min(40/104,38.46%)、30~120 min(11/104,10.58%)及120 min后(22/104,21.15%)。AVNRT组与AVRT组年龄、男性占比、心率、QRS波宽度、右束支传导阻滞发生率差异有统计学意义(P=0.028)。AVRT患者中有症状组与无症状组相比心率差异有统计学意义(P=0.012)。结论十二导联穿戴式心电设备能够成功记录SVT患者的心电图特征,同时两种SVT机制的患者在心率、年龄构成、性别构成以及穿戴式心电图特征存在一定差异,患者能随时随地记录心电图并在发作后即刻上传,迅速获得诊断,具有极大的便利性。Objective To explore the application value of twelve-lead wearable electrocardiogram(ECG)devices for pre-hospital diagnosis of supraventricular tachycardia(SVT).Methods A total of 356 patients diagnosed with supraventricular tachycardia using 12-lead wearable ECG devices from April 2017 to August 2021 were selected.According to the wearable ECG,the SVT mechanism was initially identified as atrioventricular nodal reentrant tachycardia(AVNRT)or atrioventricular reentrant tachycardia(AVRT).The brief main complaints and ECG characteristics of the two groups were analyzed retrospectively.Results The accuracy of the automatic diagnostic model of twelve-lead wearable ECG device for supraventricular tachycardia was 98.43%.The assessing process consumed 113(77~175)seconds while the auditing process consumed 73.5(32~143.25)seconds.The application scenarios are divided into hospital clinics(69/104,66.35%),home records(30/104,28.85%),work units(3/104,2.88%),driving(1/104,0.96%)and outdoor roadside(1/104,0.96%).The time points were recorded immediately after the attack(31/104,29.81%),10~30 minutes after the attack(40/104,38.46%),30~120 minutes(11/104,10.58%),and 120 minutes later(22/104,21.15%).There were significant differences in age(P<0.001),male proportion(P=0.011),heart rate(P=0.005),QRS wave width(P=0.018)and incidence of right bundle branch block(P=0.028)between AVNRT group and AVRT group.There was a significant difference in heart rate in the symptomatic group compared with the asymptomatic group in AVRT patients(P=0.012).Conclusion The twelve-lead wearable ECG device can successfully record the ECG characteristics of SVT patients,and there are certain differences in heart rate,age composition,gender composition,and wearable ECG characteristics between patients with 2 types of SVT.Patients can record the ECG anytime and anywhere,then upload it immediately after the attack and quickly obtain diagnosis,which has great convenience.

关 键 词:穿戴式心电设备 室上性心动过速 房室结折返性心动过速 房室折返性心动过速 

分 类 号:R54[医药卫生—心血管疾病]

 

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