261例心悸、胸闷患者动态心电图分析

Analysis of Dynamic Electrocardiogram in 261 Patients with Palpitation and Chest Tightness

目的探讨发作性心悸、胸闷时是否发生心律失常及心律失常的主要类型。方法对261例发作性心悸、胸闷患者记录的动态心电图进行分析。结果动态心电图显示261例中140例发生心律失常,心律失常发生率53.6%,心律失常发生的类型60岁以上组以室性期前收缩为主,其次是快速房颤、短程阵发性房性心动过速以及高度房室传导阻滞或窦性停搏等。心律失常发生率60岁以上组和60岁以下组比较,两者差异有统计学意义(χ2=26.75,P<0.001)。结论老年人发作性心悸、胸闷时多发生严重心律失常。快速心律失常以多发多源室性早搏伴短阵发性室性心动过速、快速房颤、短阵发性房性心动过速多见。缓慢性心律失常以高度以上房室传导阻滞及窦性停搏多见。老年人发生一过性严重心律失常是导致心悸、胸闷等症状的主要原因之一。

Objective To study whether the arrhythmia occurs on the onset of palpitation and chest tightness, and to investigate the main types of arrhythmia. Methods The dynamic electrocardiogram records of 261 patients with heart attack and chest tightness were analyzed. Results Arrhythmia occurred in 140 out of 261 cases of Holter monitoring, with the incidence rate of 53.6 %. The main type of arrhythmia occurred in the patients aged 60 years and over was ventricular premature beat, followed by rapid atrial fibrillation, short paroxysmal atrial tachycardia, advanced atrioventricular block or sinus arrest, and so on. There were statistically significant differences in the incidence rate of arrhythmia between the age group of 60 years or over and the age group of below 60 years （Х^2 = 26.75, P〈 0. 001 ）. Conclusions The onset of palpitation and chest tightness in elderly patients is usually accompanied by serious arrhythmias. Multiple sources and more premature ventricular contractions with a short paroxysmal ventricular tachycardia, rapid atrial fibrillation, and short paroxysmal atrial tachycardia are the most common in tachyarrhythmias, while advanced atrioventricular block or sinus arrest is the most common in slow arrhythmia. The occurrence of severe arrhythmia is one of the main reasons that caused palpitation and chest tightness in elderly patients.