24小时动态心电图检查在起搏器植入心律失常诊断中应用价值分析

The Application value of 24-hour Dynamic Electrocardiography for the Diagnosis of Arrhythmia in Patients undergoing Pacemaker Implantation

目的:分析24 h动态心电图检查在起搏器植入心律失常诊断中的应用价值。方法:选择2013年2月~2016年1月于医院接受起搏器植入术治疗的60例患者作为研究对象,均采用常规12导联及24 h动态心电图进行检查,比较两种不同检查方法对心律失常的诊断价值。结果:①24 h动态心电图对心室过感知、心房感知不良、心室感知不良检出率均高于12导联心电图(P<0.05)。②24 h动态心电图心律失常总检出率明显高于12导联心电图(P<0.05)。③24 h动态心电图HRV时域指标24 h内所有正常R-R间期标准差(SDNN)、24 h内相邻正常R-R间期之差均方根值(RMSDD)、全程每5 min时间段R-R间期均值标准差(SDANN)均高于12导联心电图(P<0.05)。结论:24 h动态心电图对起搏器植入术后起搏功能异常、感知功能异常及心律失常检出率高,且对心率变异性诊断相对敏感,对起搏器植入心律失常诊断的临床应用价值较12导联心电图更高。

<Objective: To analyze the application value of 24 h dynamic electrocardiography(ECG) for the diagnosis of arrhythmia in patients undergoing pacemaker implantation. Methods: 60 patients undergoing pacemaker implantation in the hospital from February2013 to January 2016 were selected as the study subjects, and they were examined by conventional 12-lead dynamic and 24 h dynamic ECG. The value of two different methods for the diagnosis of arrhythmia was compared. Results:①The detection rates of ventricular perception, atrial poor sensation and ventricular poor sensation detected by 24 h dynamic ECG were all higher than those by 12-lead ECG(P<0.05).②The total detection rate of arrhythmia by 24 h dynamic ECG was higher than that of 12-lead ECG(P<0.05).③The HRV time-domain indexes of 24 h dynamic ECG [standard deviation of normal number of intervals(SDNN), the root mean square of successive heartbeat interval difference(RMSDD), standard deviation of sequential five-minute R-R interval means(SDANN)] were higher than those 12-lead ECG(P<0.05). Conclusion: 24-h dynamic electrocardiogram has a high detection rate of pacing dysfunction, perception dysfunction and arrhythmia after pacemaker implantation, the diagnosis of heart rate variability is relatively sensitive. The clinical value of pacemaker implantation arrhythmia diagnosis is superior to that of 12 lead ECG.