扩张型心肌病49例24小时动态心电图分析

目的观察分析扩张型心肌病（dilated cardiomyopathy,DCM）24小时动态心电图监测（twenty-four-hour ambulatory electrocardionraphic monitoring也称Holter）改变。方法 49例确诊为DCM患者,行Holter监测,分析这些患者24小时动态心电图发生的改变。结果所有患者Holter均有异常改变,以室性心律失常最常见,共47例（95.92%）;房性心律失常次之,共38例（77.55%）;ST-T改变14例（28.67%）,传导阻滞13例（26.53%）等。且心功能越差,复合性心律失常越多见,左房内径（leftatrialdiameter,LAD）越大,复合性房性心律失常越多见,左室舒张末期内径（Left ventricularend diastolicdimen-sion,LVED）越大,复合性室性心律失常越多见。结论 DCM患者24小时动态心电图表现多种多样,心律失常发生率高,且多样、易变。DCM患者早期进行心电图及Holter检测对早期发现心律失常及预后有重要意义。

Analysis of 24-hour Ambulatory Electrocardionraphic Monitoring on 49 Cases of Dilated Cardiomyopathy

[Objective]To observe the change of 24-hour ambulatory electrocardionraphic monitoring （Holter） on dilated cardiomyopathy （DCM）.[Methods]Holter monitoring was performed in 49 confirmed DCM patients,and the changes of 24-hour ambulatory electrocardiogram were analyzed.[Results]All patients had abnormal changes in Holter monitoring,there were 47 （95.92%） cases of ventricular arrhythmia,which took the first place,followed by atrial arrhythmia for 77.55% （38 cases）,ST-T changes were detected in 14 cases （28.67%）,and conduction block were detected in 13 cases （26.53%）. The worse the cardiac function was,the more complex arrhythmia there was. The incidence of complex atrial arrhythmia increased with the increase of left atrial diameter （LAD）,and the incidence of complex ventricular arrhythmia increased with the increase of left ventricular end diastolic dimension （LVED）.[Conclusion]The manifestations of 24-hour ambulatory electrocardionraphic monitoring of DCM patients were various,the incidence of arrhythmia was high,and it had the characteristics of multiform and inconstant. Early electrocardiogram detection and Holter monitoring in DCM patients has great important significance on early discovery and prognosis of arrhythmia.