单导联长程心电监测筛查心房颤动的有效性研究  

Effectiveness of single-lead long-term electrocardiogram monitoring for screening atrial fibrillation

作　　者：周乐 何星星 孔祥怡 王珏[1] 巫莹钢 夏逸飞 余成 左嵩[1] 桑才华[1] 龙德勇[1] 马长生[1] ZHOU Le;HE Xingxing;KONG Xiangyi;WANG Yu;WU Yinggang;XIA Yifei;YU Cheng;ZUO Song;SANG Caihua;LONG Deyong;MA Changsheng(Department of Arrhythmia,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心律失常中心,100029 [2]衢州市第二人民医院 [3]衢州市第二人民医院医共体杜泽分院

出　　处：《心肺血管病杂志》2025年第2期123-127,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家重点研发计划项目(2022YFC3601303)。

摘　　要：目的:本研究旨在评估贴片式单导联长程(7日)动态心电监测在检测心房颤动中的有效性。方法:研究对象为2024年4月15日至2024年5月28日浙江省衢州市衢江区杜泽乡≥60岁的居民。所有入选者接受12导联心电图检查后,佩戴贴片式单导联动态心电监测设备连续监测7天。心律分析由心房颤动分析软件完成,并由两位心内科医生确认结果。比较12导联心电图与单导联监测的心房颤动检出率。结果:共纳入1 233例研究对象,平均年龄(65.2±4.5)岁,男性58%。12导联心电图诊断心房颤动27例(2.2%),其中持续性心房颤动26例(2.1%),阵发性心房颤动1例(0.1%)。单导联长程心电监测1 205例(97.7%),中位佩戴时间3.9(1.9,5.3)d,诊断心房颤动53例(4.4%),其中持续性心房颤动27例(2.2%),阵发性心房颤动26例(2.2%)。阵发性心房颤动的检出率在佩戴2~4天最高(46.2%),单导联监测对阵发性心房颤动的检出率显著高于12导联心电图(2.2%vs. 0.1%,P<0.001)。期间不良事件共发生15例(1.24%)皮肤过敏,无其他不良事件。结论:贴片式单导联长程动态心电监测显著提高了老年人心房颤动的检出率,尤其对阵发性心房颤动的检测效果突出。该监测方式为心房颤动早期诊断及治疗提供了重要工具,有望改善患者预后。Objective:This study aimed to evaluate the effectiveness of long-term(7-day)patch-based single-lead electrocardiographic(ECG)monitoring in detecting atrial fibrillation(AF).Methods:Residents aged 60 years or older,living in Duze Township,Qujiang District,Quzhou City,Zhejiang Province,were enrolled between April and May 2024.All participants first underwent a standard 12-lead ECG,followed by continuous patch-based single-lead ECG monitoring for 7 days.After 7 days,single-lead ECG data were collected and analyzed using AF detection software.All cases identified as AF by the software were reviewed and confirmed by two cardiologists.The AF detection rates of the 12-lead ECG and the single-lead long-term ECG monitoring were then compared to assess their effectiveness.Results:A total of 1233 residents were enrolled,with an average age of(65.2±4.5)years;58%were male.All participants underwent 12-lead ECG testing,and 1205 of them(97.7%)also completed the single-lead long-term ECG monitoring,with a median device-wearing time of 3.9 days(range:1.9-5.3days).Among the 1233 participants who had a 12-lead ECG,27(2.2%)were diagnosed with AF.Of these,26(2.1%)were confirmed as having persistent AF,and 1(0.1%)had paroxysmal AF,based on subsequent patch-based single-lead long-term ECG monitoring.In contrast,among the 1,205 participants who underwent patch-based single-lead long-term ECG monitoring,53(4.4%)were diagnosed with AF,including 27(2.2%)with persistent AF and 26(2.2%)with paroxysmal AF.The highest detection rate for paroxysmal AF was observed within 2-4 days of monitoring(46.2%).Long-term dynamic monitoring significantly increased the detection rate of paroxysmal AF(2.2%vs.0.1%,P<0.001).Additionally,15 cases of skin allergies(1.2%)were reported during the monitoring period,with no other adverse events.Conclusions:Long-term patch-based single-lead ECG monitoring significantly improved the detection rate of AF in the elderly,particularly for identifying paroxysmal AF.The application of this monitoring method may facilitate

关 键 词：心房颤动 动态心电监测 筛查 可穿戴设备 心电贴 

分 类 号：R54[医药卫生—心血管疾病]