新生儿窦性心动过缓和窦性停搏引发交界性节律的心电特征

Electrocardiography characteristics of junctional rhythms after sinus bradycardia and sinus arrest in newborns

目的分析新生儿窦性心动过缓和窦性停搏引发交界性节律的心电特征。方法 6例新生儿,通过心电散点图逆向技术对时间RR间期(t-RR)散点图中振幅较高的散点逆向出片段心电图,诊断为交界性逸搏或/和交界性自主节律,分析散点图整体特征及心电动态变化规律。结果 6例患儿,年龄(11±2)天,心率(135±8)次/分,出现交界性心搏时的窦性心律性质为窦性心动过缓者2例,窦房传导阻滞者4例,窦性停搏者4例。24ht-RR散点图均为梳齿状,1ht-RR散点图呈λ形,Lorenz-RR散点图在45度线远端或者两侧呈稀疏散点分布。交界性心搏的RR间期变化。结论新生儿窦性心动过缓和窦性停搏引发交界性逸搏时t-RR散点图呈梳齿状或λ形,可反映心脏兴奋点的生理和病理节律变化特征。

Objective To analyze the electrocardiography （ECG） characteristics of junctional rhythms after sinus bradycardia and sinus arrest in newborns. Methods Six newborns were diagnosed as junctional escape or / and junctional autonomic rhythms by reverse technique of the time RR interval （t-RR） scatter plot with a higher amplitude. The overall characteristics of scatter plots and dynamic changes of ECG were also analyzed. Results The average age of the 6 newborns was （11＋2） days and the average heart rate was （135±8） bpm. Among the 6 cases of junctional rhythms, 2 were caused by sinus bradycardia, 4 were caused by sinus atrial block and 4 were caused by sinus arrest. The 24 h t-RR scatter plot of all the cases was comb shape, the 1 h t-RR scatter plot was λ pattern, and the Lorenz-RR scatter plot was sparsely scattered on the distal or both sides of the 45-degree line. The RR intervals of junctional rhythms were changed . Conclusion The t-RR scatter plot of the junctional rhythms after sinus bradycardia and sinus arrest in newborns resulted in a comb-shaped or λ pattern , which can reflecting the physiolog- ical and pathological rhythm change characteristics of neonatal cardiac excitation point