体表窦房结电图对窦房结功能障碍诊断价值的研究

A STUDY OF DIAGNOSTIC VALUE OF SINUS NODE DYSFUNCTION BY BODY SURFACE SINUS NODE ELECTROGRAM

目的 :探讨体表窦房结电图 ( SNEb)对窦房结功能障碍 ( SND)的诊断价值。方法 :采用 SNEb、心电图 ( ECG)、动态心电图( DCG)、经食管心房调搏 ( TEAP)、运动试验及阿托品试验 ,对病态窦房结综合征 (病窦 )病人 ( 3 5例 )、单纯窦性心动过缓 (窦缓 )者 ( 2 0例 )及正常人 ( 3 0例 )进行比较研究。结果 :SNEb对 SND诊断的阳性率达 74.3 % ,优于 ECG,与 DCG和 TEAP结果相似。在 SNEb监测下进行阿托品试验和 TEAP检查 ,能提高二者对 SND的阳性检出率。 SNEb直测的窦房传导时间 ( SACTd)在病窦组其均值大于窦缓组和正常组 ( P<0 .0 1) ,并且与 TEAP测定的间接窦房传导时间 ( SACTi)有相关性。结论 :SNEb作为一种无创伤检查手段能直接描记窦房结电位 ,对

The body surface sinus node electrogram (SNEb),electrocardiography (ECG),dynamic electrocard iography(DCG) and transesophageal atrium pacing (TEAP) electrophysiological testing were performed in 35 patients with sinus node dysfunction (SND), 20 cases with simple sinus bradycardia and 30 normal subjects in whom diagnostic value of SNEb in SND was studied.The results showed that SNEb had a positive rate of 74.3%, better than ECG and similar to DCG and THAP methods in diagnostic effects. The sensitivities of DCG and TEAP methods could be increased by simultaneous monitoring of SNEb. An average of the direct sinoatrial conduction time (SACTd) measured by SNEb in SND group was longer than that in simple bradycardial group and normal group,and SACTd had a positive correlation with the indirect sinoatrial conduction time (SACTi) measured by TEAP methods (γ=0.5831).The SNEb, a non-invasive technique,has a unique clinical value in detecting SNP and differentiating atrial arrthythmias.