远程心电监护对心律失常判断价值的探讨

Clinical significance of electrocardiogram telemonitoring recorder in diagnosis of arrhythmia

目的探讨远程心电监护仪诊断心律失常的临床价值。方法采用12导联心电图和远程心电监护仪分别检查51例心脏病患者。以12导联心电图诊断作为"标准",与远程心电监护仪检查结果进行比较,观察两种方法诊断心律失常符合率。结果51例患者中,12导联心电图显示47例伴有心律失常(92.2%),远程心电监护仪发现48例心律失常(94.1%),两组间差异无统计学意义(P>0.05);心律失常中房颤18例,室性早搏14例,房颤合并室性早搏7例,Ⅰ度房室传导阻滞6例,窦性心动过速、室性心动过速和右束支传导阻滞各4例,左束支传导阻滞、窦性心动过缓和室性早搏二联律各3例,交界性心动过速、心房扑动、起搏心律、预激综合征和Ⅱ度Ⅰ型房室传导阻滞各1例。结论远程心电监护仪对心律失常的诊断符合率高,进入家庭和社区使用,使院外心血管病患者及高危人群得到有效监测,能及时识别致命性心律失常,及早报警从而降低院外因恶性心律失常发生心脏性猝死危险。

Objective To evaluate the clinical significance of electrocardiogram telemonitoring recorder in diagnosis of arrhythmia.Methods Fifty-one patients,25 males and 26 females,aged(56.6±17.1)(14～92),with heart diseases underwent electrocardiography and examination with electrocardiogram telemonitoring recorder.The accordance rate of these 2 methods in the diagnosis of cardiac arrhythmia was compared.Results Forty-seven of the 51 patients were diagnosed as with cardiac arrhythmia by electrocardiography with an incidence rate of 92.2%,not significantly different from that by using electro- cardiogram telemonitoring recorder(94.1%,48/51,P>0.05).The abnormal ECG findings included atrial fibrillation(n= 18),premature ventricular contraction(n=14),first degree atrioventricular block(n=6),atrial fibrillation complicating with premature ventricular contraction(n=7),sinus tachycardia(n=4),ventricular tachycardia(n=4),right bundle branch block(n=4),left bundle branch bloc(n=3),sinus bradycardia(n=3),premature ventricular contraction bigeminy(n= 3),junctional tachycardia(n=1),atrial flutter(n=1),pacing ECG(n=1),W-P-W syndrome(n=1),and second de- gree A-V block Mobitz type I(n=1).Conclusion With the possibility of monitoring the discharged patients and potential patients in family and community,electrocardiogram telemonitoring recorder is helpful in diagnosis of arrhythmia promptly,thus decreasing the danger of sudden cardiac death outside hospital.