动态心电图检测心房颤动伴长R-R间期48例临床分析

目的:探讨心房颤动伴长R-R间期48例的临床意义.方法:选择心房颤动48例合并长RR间期的患者检测12导联动态心电图,对结果以及发生时间和症状进行总结分析.结果:房颤病例中伴长R-R间期发生率男性患者略高于女性患者.发生频率夜间明显高于白天,心室率越快,长间期越少,心室率越慢,长间期越多.房颤合并Ⅱ度房室传导阻滞患者出现长间期持续时间长,且出现时间比较频繁.室性逸搏或交界性逸搏多出现于房颤合并Ⅱ度房室传导阻滞后.结论:房颤时凡心室率较慢,有长的R-R间期＞2.5 s,且长R-R间期出现次数明显增加并与睡眠不相关,又出现头晕或晕厥病史者,应考虑病理性房室传导阻滞,频发的持续性较长的长R-R间距,同时伴有脑缺血的症状,以及减慢心室率药物引起的症状性心动过缓,而该药物又不能停用则都是起搏器治疗的指征.

Clinical analysis of dynamic cardiogram in testing 48 patients with atrial fibrillation combined with long R-R pause

Objective: To investigate the clinical significance of 48 cases of atrial fibrillation(AF) combined with long R-R pause.Methods: 48 AF combined with long R-R pause patients were selected and performed 12-lead dynamic cardiogram(DCG),and the outcome,occurrence time and symptoms were summarized and analyzed.Results: The occurrence rate of AF combined with long R-R pause was higher in male than in female,higher in the night time than in the day time.The faster the wentricular rate is,the less long pause,and vice versa.AF combined with secondary degree AV block patients’ pauses lasted long and appered more frequently.Ventricular escape beat or junctional escape beat was found more often after AF combined with secondary degree AV block.Conclusions: 1.When AF occurred,if patients are with the symptoms of slower ventricular rates,long R-R pauses > 2.5 seconds appearing more frequent and the medical history of dizziness and syncope,they should be diagnosed with pathological atrioventricular block;2.If frequent and long-lasting long R-R pauses appear in patients combined with the symptom of cerebral ischemia at the same time,of symptomatic bradycardia caused by drugs reducing ventricular rates and drugs can’t be withheld for patients.These are the indications that the patients should be treated by pacemaker.