植入型心电监测仪长程监测的应用研究

Application of long-term monitoring of insertable cardiac monitor

目的探讨植入型心电监测仪（ICM）在长程监测领域的临床价值。方法入选2016年2月至2017年11月北京医院心内科因不明原因晕厥或心悸患者30例，均植入新一代植入型心电监测仪Reveal LINQ进行长程监测。结果入选30例患者（晕厥查因27例，心悸查因3例），平均随访（7．6±3．5）个月，12例再发晕厥或前兆晕厥，明确诊断9例，诊断率为75．0％，其中心源性晕厥占66．7％。30例患者监测到7例发作房性心动过速（房速）／心房颤动（房颤），其中无症状房颤占28．6％。诊断1例阵发性室上性心动过速并接受导管消融治疗。结论植入型心电监测仪能够长程、连续、完整、精确地记录心电活动，为临床诊断提供帮助。

Objective To evaluate the clinical value of the insertable cardiac monitor （ ICM ） in the field of long-term monitoring. Methods A total of 30 patients with syncope or palpitation from February 2016 to November 2017 were implanted with ICM （ Reveal LINQ LNQI1, Medtronic Inc. ）. Results During the monitoring period （ 7.6 ± 3.5 ）months, a total of 12 patients had recurrent syncope or pre-syncope, the ICM- guided diagnosis rate was 75.0%, of which 66.7% was cardiogenic syncope. Seven patients were found to have atrial tachycardia/atrial fibrillation, of which asymptomatic atrial fibrillation accounted for 28.6%. One patient was diagnosed with paroxysmal snpraventricular tachycardia. Conclusion ICM can long-term monitor the cardiac electrical activity and provide evidence for clinical diagnosis.