远程心电诊断在起搏器术后管理中的价值

The Value of Remote Electrocardiogram Diagnosis in Management of Patients After Pacemaker Implantation

目的同期比较远程心电诊断中心和三级医院心电图室,起搏心电图的占有率和起搏器障碍的检出率。方法 2015年4月16日~2015年7月15日,上海交通大学远程心电诊断中心（简称诊断中心）和上海交通大学医学院附属瑞金医院心脏科心电图室（简称心电图室）,所有数字化心电图数据入选统计分析。结果诊断中心心电图检查共262399人次,其中检出起搏心电图共841人次（773例病例）,占0.32%,心电图室心电图检查共29214人次,其中检出起搏心电图共236人次（155例病例）,占0.81%,心电诊断中心起搏心电图占有率显著低于心电图室（p=0.000）;诊断中心检出起搏器故障共23例（2.98%）,心电图室检出起搏器故障共3例（1.94%）,诊断中心起搏器故障检出率高于心电图室,但无统计学差异（p=0.602）。结论远程心电诊断中心起搏心电图的实际病例数高,检出起搏器故障高,远程心电诊断在起搏术后管理中有重要的价值。

Objective The aim of this study is to compare the rate of pacemaker electrocardiogram （ECG） and the positive rate of malfunction pacemaker in the remote center for electrocardiogram diagnosis and the third grade hospitals. Methods Total digital ECGs recorded during April16, 2015 to July 15, 2015 in the Shanghai Jiaotong University Remote Electrocardiogram Diagnosis Center （abbr.： Center） and the Shanghai Jiaotong University Aff＇diated Ruijin Hospital Electrocardiogram Department （abbr.： Department ） were admitted into statistical analysis. Results The total number of digital ECGs was 262399 in the Center. There were 841 pacemaker ECGs recorded from 773 patients after pacemaker implantation. The rate of pacemaker ECGs was 0.32%. The total number of digital ECGs was 29214 in Department. There were 236 pacemaker ECGs recorded from 155 patients after pacemaker implantation. The rate of pacemaker ECGs was 0.81%. The rate of pacemaker ECGs in the Center was significantly lower than that in the Department （p= 0.000）. 23 patients in the Center and 3 patients in the Department were detected pacemaker abnormalities. The positive rate of malfunction pacemaker in the Center （2.98%） was higher than that in the Department （1.94%）, but there was no significance （p-- 0.602）. Conclusions The actual number of pacemaker ECGs and patients with pacemaker abnormalities was high in the Remote Electrocardiogram Diagnosis Center, suggesting that the remote electrocardiogram diagnosis is valuable in the management of patients after pacemaker implantation.