动态心电图对房性早搏诱发的阵发性心房颤动的诊断价值

The value of Holter monitoring in diagnosing paroxysmal atrial fibrillation triggered by premature atrial contraction

目的探讨阵发性心房颤动与房性早搏的关系。方法对26例经动态心电图诊断为阵发性房颤的病人,统计房早个数、房颤的发作阵数,诱发房颤的房早联律间期、房早前周期,未诱发房颤的房早联律间期、房早前周期等。结果26例阵发性房颤患者中,24h平均房早11126±2018个,阵发性房颤248±56阵。其中22例(84.6%)由房早诱发,2例(7.68%)由短阵房速诱发,2例(7.68%)由房扑诱发。能够诱发房颤的房早联律间期及房早前周期分别为361.8±42.9ms和828±101ms,未诱发房颤的房早联律间期及房早前周期分别为426.6±43.5ms和728±107ms,诱发房颤的房早联律间期明显短于未诱发房颤的房早联律间期,呈PonT现象,诱发房颤的房早前周期比未诱发房颤的房早前周期长(p<0.01)。结论阵发性房颤主要由房早始动,其与房早的联律间期及前周期有关。

Objective To investigate the relationship between paroxysmal atrial fibrillation（PAF） and premalure atrial contraction（PAC）. Methods 26 cases of PAF diagnosed by Halter were enrolled, we accounted the total numbers of PAC and the bursts of PAF, the coupling interval of PAC, the circle length before PAC which could or could not induce PAF. Results PAF was induced by PAC in 22 cases and by paroxysmal tachyeardia in 2 cases and by atrial flutter in 2 cases. The coupling interval of PAC, the circle length before PAC which could induce the PAF were 361,8±42,9ms, 828±101ms respectively, in those could not induce AF were 426.6±43.5ms, 728±107ms respectively. It was significant that the intervals of PAC induced PAF were shorter than those didn＇t induce PAF（p〈0.01）, the circle length before PAC which could induce the PAF was longer than that could not induce（p〈0.01）. Conclusion PAF is not only mosdy triggered by PAC, hut also in relation with the coupling interval and the circle length before PAC.