加速性房性或房室交接区逸搏心律动态心电图心率分析

Analysis of Accelerating Atrial or Junctional Escape Rhythm on Dynamic Electrocardiogram

目的探讨加速性房性或房室交接区逸搏心律的24h动态心电图变化特征。方法选取加速性房性或房室交接区逸搏心律患者53例．采用24h动态心电图分别测定和比较窦性最快和最慢心率、加速性房性或房室交接区逸搏心律的最快和最慢心率。结果窦性心律的心率变化范围（57．92±7．58）～（125．85±25．87）次／min．明显大于房性或房室交接区心律的心率变化范围（59．82±9．13）～（88．42±17．36）次／min，两者最快心率比较差异有显著统计学意义（P〈0．01），最慢心率比较差异无统计学意义（P〉0．05）。结论窦性心律和房性或房室交接区心律的重叠部分基本为前者心律的最低至后者心律的最高心率。节律转换时的心率相近，易出现竞争心律或房性融合波，房性或房室交接区性心率在一定时间内节律相对较稳定。

Objective To explore the circadian variation of accelerating atrial or junctional escape rhythm. Methods The highest and lowest rates of sinus rhythm and accelerating atrial or junctional escape rhythm were determined based on ambulatory electrocardiogram, respectively, in 53 cases with accelerating atrial or junctional escape rhythm. Results The range of sinus rate was 57.92 ±7.58 - 125.85 ± 25.87 bpm, higher than that of atrial or junctional escape rate （ 59.82± 9.13 ～ 88.42 ±17.36 bpm ）. The highest rate, but not the lowest rate, was significantly different between sinus rhythm and atrial or junctional escape rhythm （P〈0.01）. Conclusion The overlapping region is from minimum sinus rate to maximum atrial or junction escape rate. Competitive rhythm and atrial fusion wave appear frequently as escape rate approaching to sinus rate.