窦性心动过缓患者做动态心电图检查的必要性

The necessity of sinus bradycardia patients taking dynamic electrocardiogram examination

目的了解窦性心动过缓(平均心率<55次/min)患者在动态心电图检查时出现的各种情况。方法选择2012年1月～2013年1月在我院门诊和住院且经常规心电图检查诊断为窦性心动过缓的患者100例。结果显著窦性心动过缓出现大于2.0s的长R-R间期时,病因以冠心病、高血压病、心肌梗死常见,长R-R间期心电图改变原因从上至下依次为显著性窦性心动过缓伴不齐占43%(43/100),未下传的房性期前收缩占21%(21/100),二度房室传导阻滞17%(17/100),二度窦房传导阻滞10%(10/100),窦性停搏9%(9/100)。结论动态心电图对显著窦性心动过缓的检测安全且有效,对能引起长R-R间期的病因分析及对各类心电图改变的正确诊断,有利于提高临床诊断率和治疗率。

Objective To acquire a knowledge of various kinds of circumstances when sinus bradycardia patients （the average heart rate55 bpm） are taking dynamic electrocardiogram （ECG） examination.Methods Select 100 cases of outpatients and inpatients from January 2012 to January 2013 who were diagnosed by routine ECG examination with sinus bradycardia.Results When obvious sinus bradycardia attacks and long R-R interval longer than 2.0 seconds appears, the usual causes include coronary heart disease, hypertension and myocardial infarction. From primary to secondary, the reasons for ECG changes of long R-R interval are as follows that obvious sinus bradycardia complicated with arrhythmia accout for 43%（43/100）, nonconducted atrial extrasystoles accout for 21%（21/100）, Ⅱ° atrioventricular block 17%（17/100）, Ⅱ° sinoatrial block 10%（10/100） and sinus arrest 9%（9/100）.Conclusion The dynamic ECG proves to be safe and effective in the examination of obvious sinus bradycardia, causes analysis of long R-R interval as well as diagnosis of a variety of ECG changes, which help to promote the diagnostic accuracy and cure rate clinically.