动态心电图诊断肌袖性房性心律失常的价值

Diagnosis of muscle sleeve atrial arrhythmias with dynamic electrocardiography

目的:探讨动态心电图在肌袖性房性心律失常诊断中的价值。方法:分析10例经心内电生理证实起源于肌袖的房性心律失常患者24h动态心电图特征。结果:10例患者动态心电图显示:在窦性心律基础上,出现频发房早,可呈房早二、三联律,频发短阵房速、房扑、房颤,房早联律间期短,多呈P’on T现象,易出现室内差异性传导、干扰性P’R间期延长、房早未下传。房性心律失常与窦律相互交替出现,呈多样性变化。结论:起源于肌袖的房性心律失常有一定规律和心电图特点,通过24h动态心电图监测,可更全面的反映其规律变化,充分展现其心电图特点,动态心电图对肌袖性房性心律失常的诊断有极其实用价值。

Objective To explore the value of dynamic electrocardiography in the Diagnosis of muscle sleeve atrial arrhythmias. Methods Analyzing the features of the dynamic electrocardiography of 10 cases of atrial arrhythmias confirmed by intracardiac electrophysiological study. Results The dynamic electrocardiography of the 10 patients demonstrated： During sinus rhythm, the premature atrial contracts happened frequently, often in the form of bigeminy or trigeminy. There were also frequent paroxysmal atrial tachycardia, atrial flutter, atrial fibrilla- tion. The majority of atrial premature contracts with a short coupling interval displayed the P on T pattern, which caused intraventricular differential conduction, interferential PR interval prolongation, atrial premature contract without conduction. Paroxysmal atrial tachycardia, atrial flutter, atrial fibrillation and sinus rhythm occurred al- ternatively. Conclusion The atrial arrhythmias originating from muscle sleeve are of certain electrocardiographic characteristics, which can be fully revealed by dynamic electrocardiography. So dynamic electrocardiography is of tremendous practical value for the diagnosis of atrial arrhythmias originating from muscle sleeve.