394例老年人动态心电图分析

Analysis of 24-hour Dynamic Electrocardiogram in 394 Elderly Population

为分析老年人动态心电图 (DCG)检查时各种心律失常、心肌缺血的检出率及最低心率情况 , 对 394例老年人查体DCG资料进行分析。结果发现 ,老年人单发室上性早搏的检出率为97.2 % ,成对为 96.2 % ,非阵发性及阵发性房性心动过速的检出率分别为 55.6%和 18.8%。单发室性早搏的检出率为 85.3% ,成对为 16.2 % ,非阵发性和阵发性室性心动过速的检出率分别为 5.6%和 1.8%。上述二种早搏不但检出率高 ,发作次数也多。最低心率 <30次 /分者 6例( 1.5% ) ,并伴有长R -R间期 ( 2 .4 6～ 7.76秒 ) ,最低心率并不随年龄增长而下降。心肌缺血 87例 ( 2 2 .1% ) ,其中 81例 ( 93.1% )为完全无症状性心肌缺血。单纯室上性或室性早搏在老年人中很常见 ,可能并无病因和预后价值。对最低心率过慢 ( <30次 /分 )及伴有心肌缺血者 ,应采取必要措施 ,以防发生意外。

To analyse the incidences of arrhythmiases, myocardial ischemia and the minimal heart rate detected by 24 hour dynamic electrocardiogram,three hundred and ninety four elderly cases of 24 hour dynamic electrocardiogram were studied.The results were shown as follows:①the incidences rates of isolated superventricular ectopic beat 97.2%,and paired were 96.2%;nonparaxysmal superventricular tachycardia (SVT) was 55.6%, and paraxysmal SVT was 18.8% respectively.The incidences rates of isolated ventricular ectopic beat and paired were 85.3%,16.2%,while nonparaxysmal ventricular tachycardia (VT) was 5.6%, paraxysmal VT was 1.8% respectively; ② 6 cases of minimal heart rate less than 30 beats per minute without subjective symptoms was found while minimal beart rate did not decline with increase of age; ③ 81 (93.1%) of 87 cases (22.1%) who showed myocardial ischemia were completely asymptomatic. It is assumed that the occurances of superventricular and ventricular ectopic beats were of no clinic significance. However,it is importmant to pay more attention to those whose minimal heart rate is less than 30 beats per minute or who has had episodes of myocardial ischemia.