电话传输远程心电监测的临床应用

The study of Transtelephonic Electrocardiography in clinical application.

目的评价电话传输远程心电监测(TTECG)的临床应用价值。方法①756例患者接受TTECG检查,对检查结果进行回顾性分析,并与同期进行的57例动态心电图(Holter)检查结果进行比较;②监测起搏器工作状态18例、随访抗心律失常药物疗效21例、经皮冠状动脉介入治疗(PCI)术后随访29例、外科手术前监测心律失常52例。结果疑诊心律失常636例中541例明确诊断,阳性诊断率为85.1%;发现高危室性心律失常55例;其中先后进行TTECG和动态心电图检查的57例患者中,TTECG确诊49例(86.0%),动态心电图确诊38例(66.7%),两种检查方法有显著性差异(p<0.05);反复发生晕厥33例患者中11例明确诊断,阳性率为33.3%,而24h动态心电图仅发现4例,两种检查方法有显著性差异(p<0.05)。结论TTECG对于偶发心律失常,尤其突发恶性心律失常的诊断和晕厥的鉴别诊断具有重要的临床意义,且明显优于动态心电图检查。

Objective To investigate the value of TTECG in clinical application. Methods ①756 patients were examined by TTECG and 57 were examined by both TTECG and Holter. Records of electrocardiogram between TTECG and Holter were compared. ②18 pacemaker and 21 antiarrhythmic patients were monitored by TTECG; 29 PCI were followed up and 52 preoperation patients were monitored by it. Resuits Among 636 suspects,541（85.06%） were diagnosed as arrhythmias by TTECG, including 55 high risk ventrieular arrhythmias. 57 suspects were examined by both TTECG and Holter,49（85.96%）were diagnosed as arrhythmias by TTECG and 38 （66.67%） were diagnosed by Holter. 33 patients with syncope,11（33. 33%）were confirmed cardiac syncope by TTECG,and 4（12.12%） were confimaed by Holter. Distinguished rates of cardiac events by TTECG were higher than those by Holter（p〈0.05）. Conclusion It is important to document the electrocardiogram by TTECG for the diagnosis and differentiation in occasional arrhythmias especially for sudden malignant arrhythmias and syneope,TTECG is superior to Holter.