Smartpatch心电记录仪在缺血性脑卒中患者中的临床应用

Clinical application of Smartpatch in patients with ischemic stroke

目的验证Smartpatch贴附式超长时程动态心电图记录仪在缺血性脑卒中患者中检出阵发性心房颤动(简称房颤)的临床价值。方法选取2018年11月至2019年8月于嘉定区南翔医院就诊,符合下列条件的予以入组:30天内新发的缺血性脑卒中既往无房颤病史的患者,年龄在40~90岁之间。Smartpatch跟踪记录心电图15天后回收,使用Smartpatch贴附式动态心电图分析系统回顾分析。统计Smartpatch发现的阵发性房颤的病例数,及其他阳性心律失常发现。结果 15天的跟踪,30例中共检出3例阵发性房颤患者,检出率为10%,首次房颤检出时间分别在第3天(房颤发作173阵,房颤负荷57.18%),第9天(房颤发作78阵,房颤负荷32.32%),第15天(房颤发作1阵,房颤负荷1.45%),首次房颤检出时间平均第9天。阵发性心房扑动(简称房扑)2例,首次房扑检出时间第2天(房扑发作256阵,房扑负荷8.20%),第1天(房扑发作240阵,房扑负荷6.67%)。其他心律失常8例。结论 Smartpatch在缺血性脑卒中患者中能大幅提高阵发性房颤的检出率。

Objective To verify the clinical value of long-term dynamic electrocardiogram Smartpatch in paroxysmal atrial fibrillation(AF) in patients with ischemic stroke. Methods From November 2018 to August 2019, patients were selected to visit Nanxiang hospital in Jiading district.Patients had no history of AF before with new-onset ischemic stroke within 30 days, aged 40-90 years, were enrolled who met the following criteria.Smartpatch tracked the electrocardiogram(ECG) for 15 days.The ECG was analyzed by Smartpatch attached ambulatory electrocardiographic analysis system.The number of cases of paroxysmal AF were detected by Smartpatch and other positive arrhythmia were counted. Results After 15 days of follow-up, 3 paroxysmal AF patients were detected in 30 patients, and the detection rate was 10%.AF was first detected on the third day(173 episodes of AF,load of AF 57.18%), on the ninth day(78 episodes of AF, load of AF 32.32%), and on the15 th day(1 episode of AF, load of AF1.45%).The average time of first AF detection was on the ninth day.There were 2 cases of paroxysmal atrial flutter.Atrial flutter was first detected on the second day(256 episodes of atrial flutter, load of atrial flutter 8.20%) and the first day(240 episodes of atrial flutter, load of atrial flutter 6.67%). There were 8 cases of other arrhythmia. Conclusions Smartpatch can significantly improve the detection rate of paroxysmal AF in patients with ischemic stroke.[Chinese Journal of Cardiac Pacing and Electrophysiology,2021,35(3):249-252]