心房颤动伴Ⅱ°房室传导阻滞的心电图诊断及心电散点图的形态特征

Electrocardiographic Diagnosis of Atrial Fibrillation Accompanied with Atrioventricular Block in Ⅱ° and Morphological Features of ECG Scatterplot

目的探讨心房颤动伴Ⅱ°房室传导阻滞的心电图诊断及心电散点图的形态特征。方法选取该院2015年7月—2017年6月收治的52例心房颤动患者为研究对象,采用动态心电监测仪对该组52例心房颤动患者连续监测24 h,心房颤动伴Ⅱ°房室传导阻滞患者心电图资料。结果该组52例患者有43例(82.69%)患者发生了>1.5 s的R-R间歇,平均间歇时间为(2.65±0.18)s,其中Ⅰ°房室传导阻滞23例(44.23%),其余29例(55.77%)均为Ⅱ°房室传导阻滞,Ⅱ°房室传导阻滞患者R-R间隔时间(2.79±0.22)s显著高于非Ⅱ°房室传导阻滞(2.58±0.15)s,心室率(76.4±1.27)次/min显著低于非Ⅱ°房室传导阻滞(88.2±1.84)次/min,差异有统计学意义(t=3.909 8、27.320 1,P<0.05);窦性心律恢复后,44例(84.62%)患者R-R间隔时间恢复正常,6例(11.54%)患者为Ⅰ°房室传导阻滞,2例(3.85%)患者为Ⅱ°房室传导阻滞;在散点图方面,Ⅱ°房室传导阻滞患者有明显的形态学特征,有均匀分布的条带,无明显下界,有明显上界,条带宽度一致。结论动态心电图较常规心电图的信息量反应更加便捷、细致、丰富,再结合心电散点图,可以给临床提供更多信息,更好的诊断心房颤动伴Ⅱ°房室传导阻滞。

Objective This paper tries to investigate the electrocardiographic diagnosis and ECG scatter pattern of atri- al fibrillation with Ⅱ° atrioventricular block. Methods A total of 52 patients with atrial fibrillation admitted to the hos- pital （from July 2015 to June 2017） were selected as the study subjects. 52 patients with atrial fibrillation were contin- uously monitored for 24 h using a dynamic electrocardiogram monitor. Electrocardiographic data were collected in pa- tients with atrial fibrillation and atrioventricular block Ⅱ°. Results In this group of 52 patients, there were 43 patients （82.69%） who had an RR interval of 〉1.5 s. The average interval was （2.65±0.18）s. Of these, 23 patients （44.23%） had atrioventricular block of I°, and the rest 29 cases （55.77%） were all with Ⅱ° atrioventricular block. The RR interval （2.79±0.22）s in patients with Ⅱ° atrioventricular block was significantly higher than that in non-Ⅱ° atrioventricular block （2.58±0.15） s. Ventricular ventricular rate （76.4±1.27） times/min was significantly lower than non-Ⅱ° atrioven- tricular block （88.2±1.84） times/min, and the difference was statistically significant （t=3.909 8, 27.3220 1, P〈0.05）; si- nus rhythm after recovery, 44 patients （84.62%） returned to normal RR intervals, 6 cases （11.54%） patients had I° atri- oventrieular block, and 2 patients （3.85%） had Ⅱ° atrioventrieular block; In point map, patients with Ⅱ° atrioventrieular block had obvious morphological features, with evenly distributed bands, no obvious lower bounds, obvious upper bounds, and uniform band widths. Conclusion Compared with conventional electrocardiogram, electrocardiogram re- sponds more easily, meticulously, and more abundantly. Combined with electrocardiogram scatter plot, it can provide more information for clinic and better diagnose atrial fibrillation with atrioventrieular block Ⅱ°.