动态心电图在扩张型心肌病植入心室同步化起博电复律除颤器后的应用研究

Application of Holter in patients with dilated myocardiopathy after implanted with CRT-D

目的:探讨动态心电图在扩张型心肌病(扩心病)植入心室同步化起博-电复律除颤器(CRT-D)后的应用效果。方法:选取2012年1月至2015年6月于我院接受治疗的80例扩心病患者,所有患者均采用植入CRT-D治疗。按照自愿原则,将患者均分为观察组和对照组。观察组采用动态心电图于植入CRT-D后进行实时监测;对照组不采用动态心电图监护。结果:治疗后两组患者的舒张末期内径、左室射血分数、舒张压、收缩压、E/A值、FS、心率变化及心律失常情况均有明显改善,与治疗前相比差异有统计学意义(P<0.05),且观察组患者的改善情况优于对照组(P<0.05)。1年之后,观察组无一例复发或病死,而对照组中有3例复发、1例病死,差异无统计学意义(P>0.05)。结论:动态心电图可有效监测患者的心电信息,有助于及时了解患者的疾病进展,具有较好的预警作用和监测作用,为疾病诊断提供可靠的临床指标,能有效改善预后,安全性高,疗效显著。

Objective： To study the application of Hoher in patients with dilated myocardiopathy （DM） after implanted with cardiac resynchronization therapy with implantable cardioversion de-fibrillator（CRT-D）. Methods： Eighty cases of DM patients treated with implanted CRT-D in our hospital from January 2012 to June 2015 were selected as research subjects. In accordance with their willingness, the patients were divided into observation group and control group. In the observation group real-time Hoher dynamic ECG monitoring was performed after the patients implanted with CRT-D, while the monitoring was not conducted in the control group. Results： The end- diastolic diameter, left ventrieular ejection fraction, diastolic blood pressure and systolic blood pressure, E/A value, the FS and arrhythmia, heart rate changes were improved significantly in patients of the two groups compared with those before the treatment, the difference being significant （P 〈 0.05 ）. The improvement in the observation group was better than that in the control group （ P 〈 0.05 ）. No recurrence or death occurred in the observation group after 1 year, but 3 cases died and 1 case recurred in the control group. The results showed that the safety of observation group was slightly higher than the control group. Conclusions： Holter can effectively monitorpatients＇ECG and help to learn about the disease progression in time. It provides a reliable clinical index for the diagnosis and treatment of the disease.