老年缓慢性心律失常200例临床分析

Clinical analysis of bradycardia in 200 elderly patients

目的:分析老年缓慢心室率患者的24h动态心电图特点并探讨缓慢性心律失常与心脏猝死的关系。方法:选择平均心室率低于60/min的老年患者200例为研究对象,分析疾病类型及发生率、心律失常发生率、各类传导阻滞的发生率、长R-R间期各类心电现象发生率及时间分布。结果:老年缓慢心室率疾病分布,以冠心病发生率最高,高血压、糖尿病次之。冠心病合并高血压、糖尿病占发生率2.5%,冠心病合并高血压占3.5%,冠心病合并糖尿病占2.5%。心律失常的发生率以房性心律失常最为多见,其次是室性心律失常。房性心律失常并室性心律失常占33.55%,显著窦性心动过缓、窦房传导阻滞并房性心律失常占4.5%。传导阻滞发生率以完全性右束支传导阻滞最高,Ⅰ度房室传导阻滞次之。室内传导阻滞发生率高于房室传导阻滞、窦房传导阻滞。长RR间期心电现象发生率依次为窦性停搏、未下传的房性期前收缩、心房纤颤伴心室长间歇等。最长RR间期达10.3s为阻滞型心室停搏,其次为6.83s的全心停搏。结论:老年患者缓慢性心律失常的发生与心脏猝死密切相关。

Objective： To analyze the characteristics of 24 h dynamic electrocardiogram of elderly patients with bradycardia.Methods： Classification and incidence of diseases in 200 cases who average heart rate was lower than 60/rain were evaluated.Results： Distribution of disease and cause of bradycardia in elderly distribution of disease was as follows： coronary heart disease,hypertension, type 2 diabetes mellitus, coronary heart disease with hypertension and type 2 diabetes mellitus （2.5 M）, coronary heart disease with hypertension （3.5%）, coronary heart disease with type 2 diabetes mellitus （2.5%）. The incidence of bradycardia was as follows： atrial premature, atrial tachycardia, atrial flutter, atrial fibrillation, premature ventricular extrasystole, ventricular tachycardia, junctional escape, ventricular escape, junetional escape rhythm, ventricular escape rhythm, The highest incidence of conduction block was complete right bundle branch block, then I degree artreoventricular block. The incidence of intra--ventricular block was higher than atrioventricular block and sinoatrial block the cause of long RR interval was as follows： sinus arrest, atrial premature nonconducting atrial premature, atrial fibrillation with long RR interval.Conclusion：The incidence of bradycardia was associated with sudden cardiac death.