急性心肌梗死后心电图QRS碎裂与患者预后关系的研究

目的：研究急性心肌梗死（AMI）后5天内心电图出现QRS碎裂（fQRS）与心功能、并发症和近期预后的相关性。方法：选取100例AMI患者观察入院3天内心电图，根据心电图QRS波群有无fQRS,分为fQRS组和无fQRS组，观察2组患者心功能，心源性死亡率和严重并发症发生率。结果：fQRS的发生率为44％，fQRS组心功能不全、严重并发症发生率均高于无fQRS组（P〈0.01），心源性死亡发生率fQRS组也高于非fQRS组（P〈0．05）。结论：AMI后出现fQRS患者并发症严霞、心功能差、死亡率高，提示预后不良。     

真性完全性左束支阻滞情况调查分析

目的：了解完全性左束支阻滞及真性完全性左束支阻滞在不同性别与年龄的发生率情况。方法分析620888例12导联静息心电图检测结果,统计完全性左束支阻滞不同年龄、不同性别的发生率情况。结果完全性左束支阻滞发生率在不同性别之间差异无显著性(Χ2=0.6771,P=0.4106),真性完全性左束支阻滞发生率在不同性别之间差异有显著性(Χ2=15.261,P<0.05)。完全性左束支阻滞发生率与年龄存在相关性(Χ2=671.8555,P<0.05);真性完全性左束支阻滞发生率与年龄存在相关性(Χ2=299.9378, P<0.05)。结论根据本研究推断女性发生真性完全性左束支阻滞即左束支传导功能彻底丧失的概率比男性低,因此在临床工作中女性出现完全性左束支阻滞应仔细判别,是否为左束支功能完全丧失,为临床治疗提供坚实的基础。     

3627例心电图的心律失常分析

本文对1983—1990年我院心内科住院病人发生心律失常3627例进行分析。结果表明,过早搏动、心房纤颤及窦性心动过缓的构成比明显增高;窦性心律失常在20—29岁年龄组中发生最高且男多于女;传导失常在50—59岁年龄组中男性明显多于女性,在60—69岁年龄组中则女性多于男性;室性过早搏动多发生于冠心病、心肌病及风湿性心脏病;心房纤颤多发于风湿性心脏病和冠心病;窦性心动过缓多发于冠心病和高血压性心脏病。心电图心律失常构成比心脏病。     

心电图与超声心动图在原发性高血压左心室肥厚诊断中的应用价值对比

目的探讨心电图（ECG）与超声心动图（UCG）在原发性高血压左心室肥厚（LVH）诊断中的应用价值。方法回顾性分析了2007年7月～2012年7月入住我院的200例原发性高血压患者的ECG与UCG的资料,对其进行统计学分析。结果 ECG检出LVH49例（24.5%）,UCG检出LVH 146例（73.0%）,二者检出率存在显著性差异（P〈0.01）。其中Ⅰ级高血压28例,ECG与UCG检出LVH比率分别为7.14%（2/28）、32.14%（9/28）;Ⅱ级高血压69例,ECG与UCG检出LVH比率分别为13.04%（9/69）、62.32%（43/69）;Ⅲ级高血压103例,ECG与UCG检出LVH比率分别为36.89%（38/103）、91.26%（94/103）。结论 ECG与UCG在原发性高血压左心室肥厚检测中存在互补关系,应综合性地运用两种方法才能提高原发性高血压LVH的检出率,从而降低原发性高血压患者的致残率及病死率。     

心电图课堂讲授方法探讨

心电图教学具有“教师难教,学生难学”的特点。从教学的开始就强调心电图在临床工作中的地位,使学生认识到学好心电图知识的必要性,是心电图教学不可缺少的环节。认真研究教学内容,适当进行教材更新、补充;设置讨论环节,制造师生互动;课件图文并茂、以图为主,讲者围绕图形进行讲述;介绍异常心电图要点与归纳所见图特点并举,将二者融会贯通等措施是提高心电图课堂讲授效果的有效方法。     

探讨心超和心电图在高血压性心脏病诊断中的临床价值

目的研究分析心脏B超以及心电图应用在高血压性心脏病临床诊断中的价值。方法抽取48例高血压性心脏病患者,将其按照每组24例划分为对照组和观察组,对照组通过心电图进行临床检查诊断,观察组则实施心脏B超检查诊断。结果观察组取得的诊断准确率为68.2%,显著高于对照组的38.7%(P0.05)。结论针对高血压性心脏病患者,采用心脏B超手段进行临床检查能够发挥良好的诊断效果,诊断准确性明显高于采用心电图检查。     

What is the most cost-effective strategy to screen for left ventricular systolic dysfunction: natriuretic peptides, the electrocardiogram, hand-held echocardiography, traditional echocardiography, or their combination?

AIMS: To assess the screening characteristics and cost-effectiveness of screening for left ventricular systolic dysfunction (LVSD) in community subjects. METHODS AND RESULTS: A total of 1392 members of the general public and 928 higher risk subjects were randomly selected from seven community practices. Attending subjects underwent an ECG, N-terminal pro-brain natriuretic peptide (NTproBNP) serum levels, and traditional echocardiography (TE). A total of 533 consecutive subjects underwent hand-held echocardiography (HE). The screening characteristics and cost-effectiveness (cost per case of LVSD diagnosed) of eight strategies to predict LVSD (LVSD <45% on TE) were compared. A total of 1205 subjects attended. Ninety six per cent of subjects with LVSD in the general population had identifiable risk factors. All screening strategies gave excellent negative predictive value. Screening high-risk subjects was most cost-effective, screening low-risk subjects least cost-effective. TE screening was the least cost-effective strategy. NTproBNP screening gave similar cost savings to ECG screening; HE screening greater cost-savings, and HE screening following NTproBNP or ECG pre-screening the greatest cost-savings, costing approximately 650 Euros per case of LVSD diagnosed in high-risk subjects (63% cost-savings vs.TE). CONCLUSION: Thus several different modalities allow cost-effective community-based screening for LVSD, especially in high-risk subjects. Such programmes would be cost-effective and miss few cases of LVSD in the community.     

置起搏器的老年人心律失常分析及随访观察

分析２５例置永久心脏起搏器的老年人缓慢性心律失常，其中以病态窦房结综合征（ＳＳＳ）多见（２２例）。原发病以冠心病为主（２１例）。随访２～６９个月，全部患者原有症状消失，生活自理。置心室按需型起搏器已能达到治疗目的，尤以双腔起搏器（ＤＤＤ）之类的生理性起搏器者生活质量明显提高。置起搏器后单纯型ＳＳＳ者心律失常有所改善，但仍有１６％发生房颤，置ＤＤＤ者尚可发生起搏介入性心动过速，随访及时发现和处理新的心律失常不可忽视。     

Comparison between Negative T waves characteristics in acute coronary syndrome and pulmonary embolism

Background

Electrocardiogram (ECG) is the first available modality used in patients with chest pain and dyspnea in emergency rooms.We aimed to study differences between acute coronary syndrome (ACS) and acute pulmonary embolism (APE) in patients presented primarily with abnormal negative T waves on their admission Electrocardiogram.

Negative flecainide test in Brugada syndrome patients with previous positive response.

Class I antiarrhythmic drug infusion has been established as the standard test to unmask Brugada syndrome. This report presents two patients with Brugada syndrome with positive flecainide response which was not reproducible in a subsequent test.