动态心电图对起搏器间歇性感知功能异常的诊断价值

目的 :探讨动态心电图检测对起搏器间歇性感知功能异常的诊断价值。方法 :采用MarquetteMars30 0 0动态心电图仪 ,对 36例 (4 9例次 )安装起搏器的患者进行随访 ,分析起搏、感知及与起搏器相关的心律失常。结果 :共检出起搏器间歇性感知功能异常 17例 (2 4例次 ) ,检出率为 4 7.2 % ,有 5例 (7例次 )合并两项感知异常。所有感知异常除 1例在常规心电图中检出外 ,其余 16例只在动态心电图中发现。检出与起搏器相关的心律失常 12例。根据动态心电图结果进行相应临床处理后 ,部分起搏器的感知功能异常消失。结论 :起搏器的感知功能异常多为间歇性的 ,动态心电图对间歇性感知异常的检出率较高 ,应是起搏器随访不可或缺的手段。

Dynamic electrocardiogram examination of sensing abnormalities in patients receiving permanent pacemaker therapy

Objective:This study is undertaken to assess pacemaker function using the dynamic electrocardiogram.Methods:We analyzed dynamic cardiograms(DCG) of 36 patients with pacemaker of various pacing mode. Pacing or sensing abnormalities and pacemaker related arrhythmias were analyzed.Results:Sensing abnormalities were found in 17 cases, among them, 16 patients with atrial or ventricular sensing abnormalities noted only on Holter monitoring. No pacing dysfunction was noted. Pacemaker related arrhythmias were found in 12 patients. After adjusted the corresponding parameters of the pacemakers according to the Holter monitoring results, sensing abnormalities disappeared in part of them.Conclusion:Holter monitoring provides important information on pacemaker function, even in patients assumed to have regular device function, and shows to be clearly superior to ECG interpretation alone. Such data can be used for adjusting programme parameters and troubleshoot.