起搏器植入患者应用24h动态心电图检查的临床意义  

Clinical significance of 24-hour ambulatory electrocardiography in patients with pacemaker implantation

作　　者：刘沛 范楠楠 LIU Pei;FAN Nannan(Department of Function,Puyang Guangci Hospital,Puyang Henan 457199,China)

机构地区：[1]濮阳广慈医院功能科,河南濮阳457199

出　　处：《实用心电学杂志》2024年第2期118-121,共4页Journal of Practical Electrocardiology

摘　　要：目的探讨起搏器植入患者应用24 h动态心电图检查的临床意义。方法选取行起搏器植入的65例患者作为研究对象,均进行常规12导联心电图及24 h动态心电图检查。对比两种检查方法对起搏器功能障碍[起搏异常、感知异常(心房感知缺失、心房过感知、心室感知缺失、心室过感知)]、起搏器特殊功能(起搏模式转换、频率应答、频率滞后、动态阈值监测、心室起搏管理)、自身心律失常(房性心动过速、阵发性心房颤动、房性早搏、室性早搏)和起搏器介导性心律失常(房室阻滞、起搏性心动过速、频率奔放、心室逸搏)的检出率。结果24 h动态心电图检查对起搏器起搏功能及感知功能障碍和起搏模式转换、频率应答等特殊功能的检出率均明显高于常规心电图(P<0.05),对自身心律失常及起搏器介导性心律失常的检出率也明显高于常规心电图(P<0.05)。结论24 h动态心电图检查可有效检测起搏器植入患者起搏器工作状态,灵敏判断起搏器功能异常及心律失常等心血管事件。Objective To investigate the clinical significance of 24-hour ambulatory electrocardiography(AECG)in patients with pacemaker implantation.Methods A total of 65 patients with pacemaker implantation were selected as research subjects,and all of them both underwent routine 12 lead electrocardiogram(ECG)and 24-hour AECG.The detection rates of pacemaker dysfunction[abnormal pacing,and abnormal perception(absence of atrial perception,atrial over perception,absence of ventricular perception and ventricular over perception)],special functions of pacemaker(pacing mode switching,frequency response,frequency lag,dynamic threshold monitoring and ventricular pacing management),self arrhythmias(atrial tachycardia,paroxysmal atrial fibrillation,atrial premature beats and premature ventricular beats),and pacemaker mediated arrhythmias(atrioventricular block,pacemaker mediated tachycardia,rapid rate and ventricular escape)separately by the two examination methods were compared.Results By using 24-hour AECG,the detection rates of pacemaker dysfunction and abnormal perception,and special functions of pacemaker such as pacing mode switching and frequency response were all significantly higher than those of routine ECG(P<0.05).The detection rates of self arrhythmias and pacemaker mediated arrhythmias were also significantly higher than those of routine ECG(P<0.05).Conclusion The 24-hour AECG examination could effectively detect the working state of pacemaker in patients implanted with pacemaker,and sensitively make judgment of pacemaker dysfunction and cardiovascular events such as arrhythmias.

关 键 词：起搏器植入 24 h动态心电图 起搏器功能障碍 心律失常 

分 类 号：R541.7[医药卫生—心血管疾病]