缓慢型心房颤动伴长R-R间期的心电图分析

目的探讨缓慢型心房颤动（Af）伴发长R-R间期在静态心电图（ECG）中发生率及意义。方法回顾性分析66例静态ECG表现为缓慢型Af的患者,根据有无伴随头晕、黑矇、晕厥等相关症状,分为有相关症状组A组37例,无相关症状组B组29例;根据年龄分为高龄组（≥80岁）42例,非高龄组（〈80岁）24例。观察缓慢型Af伴发长R-R间期发生率并进行比较分析。结果 A组发生长R-R间期30例,占81.08%,B组发生6例,占20.69%。A组发生率高于B组（χ2=10.87,P〈0.05）;高龄组发生29例,占69.05%,非高龄组发生7例,占29.17%,高龄组发生率高于非高龄组（χ2=11.63,P〈0.05）。结论静态ECG检查可以及时发现缓慢型Af伴发长R-R间期,对伴发头晕、黑矇、晕厥等相关症状患者和高龄患者应高度重视,适当延长ECG描记时间,详细描述长R-R的长度,慎重Af合并二度房室传导阻滞诊断,为临床医生尽早干预和处理提供依据,从而改善患者的症状和预后。

Analysis of electrocardiogramsof atrial fibrillation patients with slow ventricular rateand long R-R interval

Objective To investigate the clinical significance and the regulation of occurrence of long R- R interval in static electrocardiogram （ECG） among atrial fibrillation （AF） patients with slow ventricular rate（ 〈 60/min）. Methods 66 static ECG cases of atrial fibrillation （AF） patients with slow ventricular rate were retrospectively analyzed in the study. The cases were divided into two groups by two different means. Group A： 37 cases with dizziness, syncope and other related symptoms; Group B： 29 cases without above-mentioned symptoms. By the age of patients, these cases were divided into Aged Group （ ≥ 80 years old, 42 cases） and Yonger Group （ 〈 80 years old, 24 cases）. The patterns of Escape beats occurrences （ and its rate） in these caseswere observed, and results were compared among groups. Results Group A had 30 cases with long R-R interval, accounting for 81.08%, which is higher than Group B （6 cases, 20.69% ）, the difference is of statistical significance（ x2 = 10. 87, P 〈 0. 05 ）. Accordingly, the Aged Group had 29 cases with long R-R interval, accounting for 69.05%, which is higher than the rate of long R-R interval occurrence in Younger Group （7 cases, 29.17% ）, the difference is of statistical significance （ x2 = 11.63,P 〈 0. 05）. Conclusions Cases of Slow AF （ventricular rate 〈 60 /min ） with long R-R interval can be discovered in time by static ECG examination, escape beats and its rate can also be observed. Special attention should be paid to aged patients more than 80 years old ands low AF patients with dizziness, syncope and other related symptoms. An extension of the ECG recording time and detailed description of the length of long R-R intervals are highly recommended for the reference of clinical diagnosis and early clinical intervention, so as to improve the prognosis. A diagnosis of AF combined with Second-degree atrioventricular block should be make very cautiously.