动态心电图对持续性心房颤动的心室率评价

目的　探讨持续性心房颤动 2 4h心室率的变化情况。方法　选持续性 AF患者 79例 ,根据是否合并心力衰竭分为非心力衰竭组与心力衰竭组 ,两组病人均行 2 4h动态心电图检查 ,采用最快心室率、最慢心室率、平均心室率、2 4h总心搏数、2 4h每小时的平均心室率等参数分析 2 4h心室率波动情况。结果　心力衰竭组因使用地高辛控制心室率 ,非心力衰竭组各心室率指标最快、最慢及平均心室率均快于心力衰竭组 ,有显著性差异 ( P<0 .0 5 ,P<0 .0 0 1) ,2 4h总心搏数也多于心力衰竭组 ,有明显统计学意义 ( P<0 .0 0 1)。AF患者 2 4h每小时平均心室率的趋势图表明 :两组病人心室率于凌晨 6:0 0开始上升 ,至上午 8:0 0～ 10 :0 0达高峰 (最快心室率非心力衰竭组为 10 3 bpm ,心力衰竭组为 87bpm ) ,而在夜间 0 :0 0～ 5 :0 0最慢 (非心力衰竭组为 76bpm ,心力衰竭组为 65 bpm ) ,两组病人均有昼快夜慢节律变化 ;心力衰竭组每小时的平均心室率均低于非心力衰竭组。结论　根据本文结果 ,建议临床于心室率高峰前用药 ,旨在有效地控制最快心室率 ,使之维持活动时合适的心室率 ,改善血流动力学变化 ,减轻临床症状

Holter for the ventricular rate assessment of sustained atrial fibrillation

Objective To investigate the change of 24h ventricular rate in sustained atrial fibrillation (AF). Methods 79 patients with AF were observed and divided into no heart failure group and heart failure group. All the patients in 24h Holter recording and analyzed parameters were the highest rate,the lowest rate,average rate,total and each hour average heart rate of 24h. Results The highest rate, the lowest rate and average rate were faster in no heart failure group than heart failure group after the heart failure group had used digoxin; There were significant differences (P<0.05, P<0.001). The total heart rate of 24h in no heart failure group were more than heart failure group and there were significant differences(P<0.001). The frequency trend figure of average ventricular rate in each hour showed: The ventricular rate of two groups began to rise at 6:00 in the morning and peak at 8:00~ 10:00Am. (the highest rate of no heart failure group is 103 bpm and 87 bpm in heart failure group). The lowest rate is at 0:00～5:00Am. (no heart failure group is 76 bpm and heart failure group is 65 bpm). Two groups had the regulative rhythm of fast in daytime and slow in the night. Conclusion We suggest that the doctor use medicine before the peak of heart rate in order to control the heart rate effectively, keep fit heart rate during action, improve cardiodynamics and reduce the clinic symptoms.