比较远程心电监测与心电图、动态心电图在心律失常及心肌缺血中的诊断价值

目的探讨远程心电监测诊断心律失常、心肌缺血的临床价值。方法采用远程心电监测检查78例明确诊断为心脏病或存在心脏不适的患者,所有患者同时行常规12导联心电图检查,其中42例患者行24h动态心电图检查。比较远程心电监测与常规心电图及24h动态心电图在心律失常及缺血性ST-T改变检出率方面的差异。结果 78例患者中,远程心电监测及常规心电图分别检出62例、46例心律失常患者(P<0.05),同时分别检出14例、6例患者心电图存在缺血性ST-T改变(P<0.05);在完善24h动态心电图检查的42例患者中,远程心电监测与24h动态心电图分别检出34例、30例心律失常患者(P>0.05),同时分别检出10例、7例心电图有缺血性ST-T改变的患者(P>0.05)。结论远程监测无论在心律失常还是缺血性ST-T改变的检出率均高于常规心电图组;远程监测对心律失常及缺血性ST-T改变的检出率与24h动态心电图无显著差异。

Comparison of diagnostic value between remote ECG monitoring, 12 lead ECG and Holter in arrhythmia and myocardial ischemia

Objective To investigate the clinical value of remote monitoring system in diagnosing patients with arrhythmia and ST-T change.Methods A total of 78 patients with heart diseases or heart symptoms were undergone 12 lead electrocardiogram(ECG) and remote ECG monitoring examination; 42 out of 78 cases received Holter examination.The recall rate of remote ECG monitoring, 12 lead ECG and Holter in the diagnosis of arrhythmia and ischemic ST-T change was compared.Results There were significant differences in the detection of arrhythmia and ST-T changes between remote ECG monitoring and 12 lead ECG (79.5% vs 59.0%,P<0.05 for arrhythmia; 17.9% vs 7%, P<0.05 for ST-T change). There was no significant difference in the detection of arrhythmia and ST-T changes between remote ECG monitoring and 24-hour Holter (81.0% vs 71.4%,P>0.05 for arrhythmia; 23.8% vs 16.7%,P>0.05 for ST-T changes). Among the 42 patients with Holter, 34 patients with arrhythmia were recorded by remote ECG monitoring while 30 patients with arrhythmia were recorded by Holter.No significant difference was found between these two methods(81.0%vs71.4%,P>0.05). 10 patients with ischemic ST-T change were recorded by remote ECG monitoring (23.8%), insignificantly different from that by ECG (7/42, 16.7%, P>0.05).Conclusion Compared with 12 lead ECG, remote ECG monitoring shows higher detection rate in diagnosing arrhythmia and ischemic ST-T changes. While compared with Holter, remote ECG monitoring failed to diagnose arrhythmia and ischemic ST-T changes.