动态心电图观察阵发性心房颤动的发生机制

THE OBSERVATION OF MECHANISM OF PAROXYSMAL ATRIAL FIBRILLATION BY DYNAMIC ELECTROCARDIOGRAM

目的:应用动态心电图观察阵发性房颤的发作特征,以探讨阵发性房颤的发生机制。方法:对41例阵发性房颤患者的动态心电图进行分析。男20例,女21例。平均年龄66±13岁。冠心病10例,高血压病8例,糖尿病3例,甲亢性心脏病2例。观察动态心电图中心律失常的特点及与阵发性房颤的关系。结果:41例患者的动态心电图均可见房性早搏。频发者23例,占56.1%(23/41)。伴阵发性心动过速及心房扑动30例,占73.2%(30/41)。伴房性早搏二联律,房性早搏未下传及长R-R间期的35例,占85.3%(35/41)。伴有窦性心动过缓11例,占26.8%(11/41)。结论:阵发性房颤的发生有多种因素,以房性心律失常最常见,其中又以房性早搏居多,早搏的联律间期越短,越容易诱发阵发性房颤。房性早搏二联律,房性早搏未下传及长R-R间期诱发阵发性房颤的原因可能为长短周期机制。部分病例存在窦性心动过缓,与阵发性房颤的关系可能是迷走神经张力增加参与影响的结果。

Objective：To apply dynamic electrocardiogram to observe the attack features of paroxysmal atrial fibrillation so that explore the mechanism of the paroxysmal atrial fibrillation.Method：The dynamic electrocardiogram of 41 patients with paroxysmal atrial frbrillation was analyzed.There are 20 male patients and 21 females.Their average age is 66±13.10 years-old.In these patients,coronary hent disease was 10 cases,hypertension 8 cases,diabetes mellitus 3 cases and hyperthyroid heart diseases 2 cases.The relationship beewet of features of arrhythmia in dynamic electrocardiogram and the paroxysmal atrial fibrillation were observed.Results：It is found that atrial premature beat can be observed in the dynamic electrocardiograms in all the 41 patients.23 patients belong to the frequent attack（56.1% 23/41）;30 cases have paroxysmal tachycardia and atrial flutter（73.2%,30/41）;35 patients have atrial premature beat with without passing down and long R-R interval（85.3%,35/41）;and 11 patients have sinus bradycardia（26.8%,11/41）.Conclusion：There are various factors in paroxysmal atrial fibrillation,atrial arrhythmia is the most common,atrial premature beat was most.The shorter the interval of premature beat,the easier the paroxysmal atrial fibrillation to occur.The atrial premature beat whth without passing dowm and long R-R interval inducing paroxysmal atrial fibrillation may be long and short period mechanism.Some of the patients have sinus bradyeardia.Its relationship with the paroxysmal atrial fibrillation may be the result of the increasing tension of vagus.