老年心房颤动患者R-R长间期的分布规律及临床意义

目的观察老年心房颤动患者R-R长间期的发作规律,探讨老年心房颤动伴R-R长间期的临床意义。方法对2005年1月-2007年12月在我院住院的96例老年心房颤动患者动态心电图及临床资料进行回顾性分析。结果96患者共发生大于1.5 s长间期共15 456次,23：00时至凌晨05：00时出现次数最多,11：00时至14：00时次之,最长R-R间隔为4.21 s,发生在02：16分;均合并其他心律失常,以期前收缩、ST-T改变及交界性逸搏多见;患者记录中均无明显自觉症状。结论老年心房颤动伴R-R长间期多发生在睡眠状态,可能与睡眠迷走神经张力增高或应用抗心律失常药物有关,绝大多数并非病理性房室传导阻滞所致。

Diurnal pattern and clinical implication of long R-R interval in elderly patients with atrial fibrillation

Aim To study the long R-R interval pattern and its clinical effects on elderly patients with atrial fibrillation （AF）. Methods The clinical data and Dynamic electrocardiography （DCG） were analyzed retrospectively in 96 elderly patients with AF associated with long R-R interval. Results A total of 15 456 times of ≥ 1.5 s long R-R intervals in 96 elderly patients occurred and the longest R-R interval was 4.21 s. The long R-R interval occurred in the two peak pattern during 24 hours. The highest peak occurred during 23：00 to 05：00 and the second peak occurred during 11：00 to 14：00. All of the patients presented with cardiac arrhythmia. The most frequent arrhythmia were premature contractions, ST-T alteration and at.rioventricular junctional escape, and no symptoms in all patients was detected. Conclusions Long R-R interval in elderly patients with AF commonly occurs in sleep, and may relate to a vagal predominance or antiarrhythmic agents. Most of them are not caused by pathological atrioventricular conduction block.