心房颤动伴长R-R间期20例动态心电图分析

心房颤动简称房颤,是常见的房性心律失常。据统计,60岁以上人群中房颤的发生率为1%,并随年龄的增加而升高。动态心电图检测常发现房颤伴长R-R间期的现象,此现象能否诊断合并Ⅱ度房室传导阻滞存在争议。本文通过对20例房颤伴长R-R间期≥2.0s患者的动态心电图结果进行分析,     

心房颤动伴长R-R间期的临床意义分析

目的探讨心房颤动伴长R-R间期的发生机制及临床意义。心房颤动(Atrialfibrillation)是临床上最常见的心律失常之一。动态心电图监测常发现心房颤动伴长R-R间期(R-R间期≥2.0s),逸搏及逸搏心律现象,以往多认为是房颤合并Ⅱ度、高度,甚至Ⅲ度房室传导阻滞。但以后人们发现许多心房颤动患者复律为窦性心律时并无Ⅱ度或高度房室传导阻滞。方法本研究对门诊及病房心房纤颤患者行动态心电图24h记录到的60例心房颤动伴长R-R间期患者的资料进行相关分析,对长R-R间期与睡眠相关或不相关的情况进行比较。结果 60例患者共出现长R-R间期(≥2.0s)526次,白天65次(12.4%),夜间461次(87.6%);平均心室率<60次/min者37例、≥60次/min者23例;60例患者的长RR间期在2.0～4.6s之间。长R-R间与睡眠相关者46例、不相关者14例。结论心房颤动伴长R-R间期多发生在夜间睡眠状态,与睡眠呈显著相关性(P<0.01),患者无明显自觉症状,为非病理性房室传导阻滞,一般无临床意义,诊断心房颤动伴Ⅱ度房室传导阻滞(AVB)时应慎重。     

心房颤动合并长R-R间期的动态心电图特征分析

目的探讨心房颤动合并长R-R间期的动态心电图(DCG)特征。方法选取2016年10月～2018年9月本院心房颤动合并长R-R间期患者100例,所有患者均给予24hDCG检查并分析其特征。结果 100例患者共出现长R-R间期14556次,其中睡眠相关者60例(60.00%)、非睡眠相关者40例(40.00%);依据检测结果分为睡眠组和非睡眠组,睡眠组最慢、最快、平均心室率明显高于非睡眠组,差异有统计学意义(P 0.05);睡眠组长R-R间期、逸搏、逸搏心律、晕厥发生率明显低于非睡眠组,差异有统计学意义(P 0.05)。结论 DCG可有效检测心房颤动合并长R-R间期情况,心房颤动合并长R-R间期多发生在夜间睡眠状态,而非睡眠时出现长R-R间期、心室率低、晕厥患者,应当予以高度重视。     

动态心电图在心房颤动伴长R-R间期的分析

目的 探讨动态心电图分析在心房颤动伴长R-R间距的临床意义.方法 回顾性分析600例动态心电图(DCG)检查结果,检出持续性房颤32例,其中房颤伴长R-R间距14例.观察长间歇出现的规律,采用最高、最低、平均率,24 h总心率,每小时平均率等参数分析房颤伴发长R-R间期的心率波动情况.结果 32例中共检出R-R间期>2.0 s 14例.结论 Af伴长R-R间期者不要轻易做出合并二度AVB诊断,可用长R-R间期请结合临床表述并由临床医生结合临床情况作出判断较为客观.     

心房颤动伴长R-R间期的动态心电图特点观察

目的观察心房颤动伴长R-R间期的动态心电图的特点。方法回顾性分析我院2013年4月至2014年12月62例阵发性心房颤动患者临床资料,根据动态心电图检测结果将患者分为两组,即睡眠相关组和睡眠无关组,分析两组患者平均心室率、长R-R间期昼夜发生频率及伴随性症状。结果睡眠相关组患者睡眠时间及非睡眠时间平均心室率大于睡眠无关组,P<0.05;睡眠相关组长R-R间期、逸搏及逸搏心律发生率明显低于睡眠无关组,P<0.05;睡眠相关组长间歇时未出现晕厥,但是睡眠无关组长间歇时有11例患者产生晕厥,且均出现在患者清醒状态下,两组差异具有统计学意义(P<0.05)。结论对心房颤动患者伴长R-R间期的动态心电图特点进行有效分析,能够对判断患者病理性或心理性房室传导阻滞提供科学依据。     

动态心电图对心房颤动伴长R-R间期发生情况的观测与分析

目的探讨心房颤动中长R-R间期的发生情况及临床意义。方法回顾性分析595例24h动态心电图显示为心房颤动患者伴长R-R间期的发生情况。595例按性别分为两组:A组:男377例,占63.36%;B组:女218例,占36.64%。结果 A组中伴长R-R间期238例,占63.13%;B组中伴长R-R间期110例,占50.46%。A组显著高于B组。结论心房颤动伴长R-R间期者较常见,其中男性更明显。     

126例心房颤动合并长R-R间期患者的动态心电图分析

目的采用动态心电图分析心房颤动合并长R—R间期（〉1．5s）、逸搏及逸搏心律患者是否存在房室阻滞。方法对126例心房颤动患者进行24h动态心电图检查,根据患者记录的生活日志,按长R—R间期、逸搏及逸搏心律出现的时间是否与睡眠有关,把患者分为A（睡眠有关组）、B（睡眠无关组）两组。结果A组发生长R—R间期1．5～2．0s,〉2．0s及逸搏及逸搏心律人平均数分别为（26．02±6．03）、（7．39±1．05）、（6．90±1．28）;B组发生长R—R间期1．5—2．0s,〉2．0s及逸搏及逸搏心律人平均数分别为（203．05±41．01）、（35．48±7．52）、（28．10±6．25）;B组明显多于A组（P〈0．01）。结论房颤伴长R—R间期、逸搏及逸搏心律与睡眠有关时,此现象非病理性房室阻滞;而房颤伴长R—R间期、逸搏及逸搏心律与睡眠无关时,应视为病理性房室阻滞。     

126例心房颤动合并长R-R间期患者的动态心电图分析

Objective To analyze the relationship between atrial fibrillation complicating long R-R interval, escape beat and escape heart rhythm and pathological atrioventricular block by dynamic electrocardiography (DCG). Methods 126 patients with atrial fibrillation were divided into group A (being related to sleep) and group B (being not related to sleep) according to the factor whether long R-R interval, escape beat and escape heart rhythm relevant to sleep. All were detected by DCG for 24 hours. Results The cases with1.5～2.0 s long R-R interval, more than 2.0s long R-R interval, escape beat and escape heart rhythm were (26.02±6.03), (7.39±1.05 ) and (6.90±1.28)in group A and (203.05±41.01), (35.48±7.52), (28.10±6.25) in group B respectively. The cases of group B were markedly more than those in group A. Conclusion Those atrial fibrillation complicating long R-R interval, escape bbeat and escape heart rhythm were related to sleep could not be deemed as pathological atrioventricular block, while those were not related to sleep could be considered pathological atrioventricular block.     

126例心房颤动合并长R-R间期患者的动态心电图分析

Objective To analyze the relationship between atrial fibrillation complicating long R-R interval, escape beat and escape heart rhythm and pathological atrioventricular block by dynamic electrocardiography (DCG). Methods 126 patients with atrial fibrillation were divided into group A (being related to sleep) and group B (being not related to sleep) according to the factor whether long R-R interval, escape beat and escape heart rhythm relevant to sleep. All were detected by DCG for 24 hours. Results The cases with1.5～2.0 s long R-R interval, more than 2.0s long R-R interval, escape beat and escape heart rhythm were (26.02±6.03), (7.39±1.05 ) and (6.90±1.28)in group A and (203.05±41.01), (35.48±7.52), (28.10±6.25) in group B respectively. The cases of group B were markedly more than those in group A. Conclusion Those atrial fibrillation complicating long R-R interval, escape bbeat and escape heart rhythm were related to sleep could not be deemed as pathological atrioventricular block, while those were not related to sleep could be considered pathological atrioventricular block.     

126例心房颤动合并长R-R间期患者的动态心电图分析

Objective To analyze the relationship between atrial fibrillation complicating long R-R interval, escape beat and escape heart rhythm and pathological atrioventricular block by dynamic electrocardiography (DCG). Methods 126 patients with atrial fibrillation were divided into group A (being related to sleep) and group B (being not related to sleep) according to the factor whether long R-R interval, escape beat and escape heart rhythm relevant to sleep. All were detected by DCG for 24 hours. Results The cases with1.5～2.0 s long R-R interval, more than 2.0s long R-R interval, escape beat and escape heart rhythm were (26.02±6.03), (7.39±1.05 ) and (6.90±1.28)in group A and (203.05±41.01), (35.48±7.52), (28.10±6.25) in group B respectively. The cases of group B were markedly more than those in group A. Conclusion Those atrial fibrillation complicating long R-R interval, escape bbeat and escape heart rhythm were related to sleep could not be deemed as pathological atrioventricular block, while those were not related to sleep could be considered pathological atrioventricular block.     

126例心房颤动合并长R-R间期患者的动态心电图分析

Objective To analyze the relationship between atrial fibrillation complicating long R-R interval, escape beat and escape heart rhythm and pathological atrioventricular block by dynamic electrocardiography (DCG). Methods 126 patients with atrial fibrillation were divided into group A (being related to sleep) and group B (being not related to sleep) according to the factor whether long R-R interval, escape beat and escape heart rhythm relevant to sleep. All were detected by DCG for 24 hours. Results The cases with1.5～2.0 s long R-R interval, more than 2.0s long R-R interval, escape beat and escape heart rhythm were (26.02±6.03), (7.39±1.05 ) and (6.90±1.28)in group A and (203.05±41.01), (35.48±7.52), (28.10±6.25) in group B respectively. The cases of group B were markedly more than those in group A. Conclusion Those atrial fibrillation complicating long R-R interval, escape bbeat and escape heart rhythm were related to sleep could not be deemed as pathological atrioventricular block, while those were not related to sleep could be considered pathological atrioventricular block.     

126例心房颤动合并长R-R间期患者的动态心电图分析

Objective To analyze the relationship between atrial fibrillation complicating long R-R interval, escape beat and escape heart rhythm and pathological atrioventricular block by dynamic electrocardiography (DCG). Methods 126 patients with atrial fibrillation were divided into group A (being related to sleep) and group B (being not related to sleep) according to the factor whether long R-R interval, escape beat and escape heart rhythm relevant to sleep. All were detected by DCG for 24 hours. Results The cases with1.5～2.0 s long R-R interval, more than 2.0s long R-R interval, escape beat and escape heart rhythm were (26.02±6.03), (7.39±1.05 ) and (6.90±1.28)in group A and (203.05±41.01), (35.48±7.52), (28.10±6.25) in group B respectively. The cases of group B were markedly more than those in group A. Conclusion Those atrial fibrillation complicating long R-R interval, escape bbeat and escape heart rhythm were related to sleep could not be deemed as pathological atrioventricular block, while those were not related to sleep could be considered pathological atrioventricular block.     

126例心房颤动合并长R-R间期患者的动态心电图分析

Objective To analyze the relationship between atrial fibrillation complicating long R-R interval, escape beat and escape heart rhythm and pathological atrioventricular block by dynamic electrocardiography (DCG). Methods 126 patients with atrial fibrillation were divided into group A (being related to sleep) and group B (being not related to sleep) according to the factor whether long R-R interval, escape beat and escape heart rhythm relevant to sleep. All were detected by DCG for 24 hours. Results The cases with1.5～2.0 s long R-R interval, more than 2.0s long R-R interval, escape beat and escape heart rhythm were (26.02±6.03), (7.39±1.05 ) and (6.90±1.28)in group A and (203.05±41.01), (35.48±7.52), (28.10±6.25) in group B respectively. The cases of group B were markedly more than those in group A. Conclusion Those atrial fibrillation complicating long R-R interval, escape bbeat and escape heart rhythm were related to sleep could not be deemed as pathological atrioventricular block, while those were not related to sleep could be considered pathological atrioventricular block.     

126例心房颤动合并长R-R间期患者的动态心电图分析

Objective To analyze the relationship between atrial fibrillation complicating long R-R interval, escape beat and escape heart rhythm and pathological atrioventricular block by dynamic electrocardiography (DCG). Methods 126 patients with atrial fibrillation were divided into group A (being related to sleep) and group B (being not related to sleep) according to the factor whether long R-R interval, escape beat and escape heart rhythm relevant to sleep. All were detected by DCG for 24 hours. Results The cases with1.5～2.0 s long R-R interval, more than 2.0s long R-R interval, escape beat and escape heart rhythm were (26.02±6.03), (7.39±1.05 ) and (6.90±1.28)in group A and (203.05±41.01), (35.48±7.52), (28.10±6.25) in group B respectively. The cases of group B were markedly more than those in group A. Conclusion Those atrial fibrillation complicating long R-R interval, escape bbeat and escape heart rhythm were related to sleep could not be deemed as pathological atrioventricular block, while those were not related to sleep could be considered pathological atrioventricular block.     

126例心房颤动合并长R-R间期患者的动态心电图分析

Objective To analyze the relationship between atrial fibrillation complicating long R-R interval, escape beat and escape heart rhythm and pathological atrioventricular block by dynamic electrocardiography (DCG). Methods 126 patients with atrial fibrillation were divided into group A (being related to sleep) and group B (being not related to sleep) according to the factor whether long R-R interval, escape beat and escape heart rhythm relevant to sleep. All were detected by DCG for 24 hours. Results The cases with1.5～2.0 s long R-R interval, more than 2.0s long R-R interval, escape beat and escape heart rhythm were (26.02±6.03), (7.39±1.05 ) and (6.90±1.28)in group A and (203.05±41.01), (35.48±7.52), (28.10±6.25) in group B respectively. The cases of group B were markedly more than those in group A. Conclusion Those atrial fibrillation complicating long R-R interval, escape bbeat and escape heart rhythm were related to sleep could not be deemed as pathological atrioventricular block, while those were not related to sleep could be considered pathological atrioventricular block.     

126例心房颤动合并长R-R间期患者的动态心电图分析

Objective To analyze the relationship between atrial fibrillation complicating long R-R interval, escape beat and escape heart rhythm and pathological atrioventricular block by dynamic electrocardiography (DCG). Methods 126 patients with atrial fibrillation were divided into group A (being related to sleep) and group B (being not related to sleep) according to the factor whether long R-R interval, escape beat and escape heart rhythm relevant to sleep. All were detected by DCG for 24 hours. Results The cases with1.5～2.0 s long R-R interval, more than 2.0s long R-R interval, escape beat and escape heart rhythm were (26.02±6.03), (7.39±1.05 ) and (6.90±1.28)in group A and (203.05±41.01), (35.48±7.52), (28.10±6.25) in group B respectively. The cases of group B were markedly more than those in group A. Conclusion Those atrial fibrillation complicating long R-R interval, escape bbeat and escape heart rhythm were related to sleep could not be deemed as pathological atrioventricular block, while those were not related to sleep could be considered pathological atrioventricular block.     

24 h动态心电图在心房颤动伴长R-R间期检查中的应用效果

目的 探讨24 h动态心电图在心房颤动(Af)伴长R-R间期检查中的应用效果。方法 回顾性分析2019年3月至2022年3月连云港市第二人民医院收治的Af伴长R-R间期患者500例的临床资料,所有患者均行24 h动态心电图检查,对患者Af伴长R-R间期发生时间进行统计,根据动态心电图检测结果分为睡眠相关组(在21:00～6:00出现长R-R间期,319例)与非睡眠相关组(非睡眠期间出现长R-R间期,181例),比较两组患者的心电图特征及逸搏心律、逸搏及昏厥发生情况。结果 两组患者的性别、年龄、NYHA分级、疾病类型及Af持续时间比较,差异无统计学意义(P>0.05);睡眠相关组最慢心室率、平均心室率及最快心室率均高于非睡眠相关组,差异有统计学意义(P<0.05);睡眠相关组的逸搏心律、逸搏及昏厥发生率均低于非睡眠相关组,差异有统计学意义(P<0.05)。结论 24 h动态心电图可有效检测Af伴长R-R间期的特征,Af伴长R-R间期多发生于睡眠状态,应密切关注Af伴长R-R间期患者的24 h心电图检查情况,及时采取干预措施。     

心房颤动伴长R-R间期临床分析

目的探讨心房颤动（A f）伴长R-R间期是否合并Ⅱ度房室传导阻滞（Ⅱ°AVB）的诊断。方法选择持续性A f患者89例,连续记录24h动态心电图（DCG）,统计1.5秒以上的长R-R间期发生时间及次数。结果89例患者出现≥1.5秒的长R-R间期78例,占87%,以1.5-2.0秒内多见,共1 896次,占72%。次为2.0-3.0秒,共698次,占26%。3.0秒以上21次,占7.6%。其中15例转复后进行随访,13例房室传导正常,1例显示P-R间期延长,达0.22秒 1例在夜间偶见Ⅱ度房室传导阻滞。结论A f伴长R-R间期者不要轻易做出合并Ⅱ°AVB的诊断,可用＂心房颤动伴心室长间期并结合临床＂表述。     

21例房颤伴长R-R间期动态心电图分析

目的探讨心房颤动（Af）伴长R-R间期时是否合并二度房室传导阻滞（AVB）的诊断。方法选择Af伴≥2.0s的长R-R间期住院患者21例,连续记录24h动态心电图（DCG）,统计2.0s以上的长R-R间期发生时间及频度,最长R-R间期,Af时最快心率、最慢心率及平均心率,阵发性Af在监测同时记录到窦性心律时的房室传导情况。结果 21例患者共出现≥2.0s的长R-R间期275次,其中白天29次,夜间246次,Af时最快心率96～183（平均120.4±25.1）次/min,最慢心率39～56（平均47.3±5.6）次/min,平均心率58～93（平均73.1±12.7）次/min,24h最长R-R间期2.1～3.0s,转复后19例房室传导正常,2例仅P-R间期延长,并显示长R-R间期大多（89.5%）发生在夜间。结论 Af伴长R-R间期者不要轻易做出合并二度AVB诊断,可用＂长R-R间期请结合临床＂表述并由临床医生结合临床情况作出判断较为客观。