动态心电图长RR间期≥3s患者中植入起搏器的情况分析

Analysis of the patients implanted a pacemaker among those with long RR interval≥3 s of dynamic electrocardiogram

目的通过对动态心电图(DCG)长RR间期≥3s患者中植入起搏器的情况进行分析,探讨DCG对长RR间期患者植入起搏器的临床参考价值。方法回顾DCG检查达到有效记录时间且记录中至少发生1次长RR间期≥3 s的患者,统计其中植入起搏器的比例并回顾植入起搏器患者(起搏组)的临床资料,比较起搏器组和长RR间期≥3 s组年龄和性别上的分布、导致最长RR间期的心律失常类别等方面的情况,回顾植入起搏器患者的临床特点、治疗和转归。结果 292例DCG长RR间期≥3 s组中植入起搏器的患者为85例,植入起搏器的比例为29.1%;起搏器组患者均有反复发作的胸闷、头晕或心悸、黑矇等症状,其中27例(31.8%)有晕厥史。两组在年龄和性别分布上无差异〔(70.4±12.9)岁vs(67.3±13.0)岁,49.4%男性vs 57.5%男性,P>0.05〕。起搏器组(n=85)和长RR间期≥3 s组(n=292)中导致最长RR间期的心律失常类别按发生率高低最多见的均为持续性心房颤动/心房扑动期间(28.2%,44.9%)、窦性停搏(28.2%,26.4%)和阵发性心房颤动/心房扑动终止后(21.2%,10.6%)。所有患者均于起搏器植入术后症状好转出院,随访中无死亡等不良事件。结论通过分析长RR间期≥3 s患者中导致最长RR间期的心律失常类别,结合患者的临床症状和病史,可为患者植入起搏器提供依据。

Objective Through analyzing the patients implanted with a pacemaker due to long RR interval I〉 3 s in dy- namic Electrocardiogram（ DCG）, to discuss the clinical reference value of DCG for related patients who need to implant a pacemaker. Methods Reviewed DCG with effective records and with long RR interval ≥ 3 s at least 1 times during check-up, counted the proportion of the patients implanted with a pacemaker and reviewed their clinical data, compared the age and sex distribution and the cause of the longest RR interval of 2 groups（ group of pacemaker implantation and group of long RR interval ≥ 3 s）. Reviewed the clinical characteristics, treatment and prognosis of the patients implanted with a pacemaker. Results there were 85 cases implanted a pacemaker of 292 cases with long RR interval ≥ 3 s, the pro- portion was 29.1%, all patients had recurrent chest uncomfortable, dizziness and palpitation, among them 27 cases （31. 8% ） had a history of syncope. The difference of the 2 groups in age and gender distribution was not significant[ （70.4 ± 12.9） years old vs （67.3 ±13.0） years old, 49.4 % of man vs 57.5% of man, P〉0.05 1- Most of the causes that lead to the longest RR interval of the 2 groups were sustained atrial fibrillation/flutter （28.2% , 44.9% ） , sinus arrest （28. 2% , 26.4% ） and termination of paroxysmal atrial fibrillation/flutter （ 21.2% , 10.6% ）. After pacemaker implanta- tion, all patients had improved symptom and discharged, there weren＇t death or other adverse events during follow-up. Conclusion Analyzing the cause of the longest RR interval in DCG, with clinical symptoms and medical history of pa- tients can provide basis for the pacemaker implantation.