永久起搏器程控在心房颤动诊断中的临床应用及意义

Clinical Application and Significance of Permanent Pacemaker Program in the Diagnosis of Atrial Fibrillation

目的:探究永久起搏器程控在心房颤动诊断中的临床应用及意义。方法:选择78例我院收治的心房颤动患者随机分为程控组和非程控组2组,其中观察组患者给与永久起搏器程控诊断,非程控组则仅给植入永久起搏器,但非程控。对比分析两组患者基本资料、房颤负荷、心房与心室起搏比、心房结构重构及左心功能、P波结果;比较永久起搏器程控诊断与临床诊断结果的差异,分析永久起搏器程控在心房颤动诊断敏感度。结果:程控组和非程控组患者的男女比例、年龄、心率失常的类型、存在的基础性疾病以及使用过的治疗药物比较,差异均无统计学意义(P>0.05);程控组和非程控组患者的房颤负荷、VP值和P波最小时限均显著小于非程控组,AP值、P波最大时限和P波离散度则显著大于非程控组(P<0.05);程控组和非程控组患者的LAD、RAD、LVEDD和LVEF值在植入前和植入后均不存在显著性差异(P>0.05)。与临床诊断结果比较可以发现,永久起搏器程控对心房颤动检出率为97.44%,且永久起搏器程控应用于诊断心房颤动敏感度高达98.72%。结论:对心房颤动患者采用永久起搏器程控进行诊断,可以在心电图检查的各项指标结果上对患者的心房颤动给与准确的判断,具有较高的临床应用价值,值得临床推广使用。

Objective:To explore the clinical application and significance of permanent pacemaker program control in the diagnosis of atrial fibrillation.Methods:Seventy-eight patients with atrial fibrillation admitted to our hospital were randomly divided into program-controlled group and non-program-controlled group.The observation group was given permanent pacemaker program-controlled diagnosis,and the non-program-controlled group was implanted permanent pacemaker,but not program-controlled.The basic information,atrial fibrillation load,atrial and ventricular pacing ratio,atrial structural remodeling,left heart function and P wave results of the two groups were compared and analyzed.To compare the difference between permanent pacemaker programmed diagnosis and clinical diagnosis and analyze the sensitivity of permanent pacemaker programmed diagnosis in atrial fibrillation.Results:There were no significant differences in the ratio of male to female,age,types of arrhythmia,existing underlying diseases and used therapeutic drugs between the program control group and the non-program control group(P>0.05).The af load,VP value and minimum time of P wave in programmed group and non-programmed group were significantly lower than those in non-programmed group,while AP value,maximum time of P wave and P wave dispersion were significantly higher than those in non-programmed group(P<0.05).There were no significant differences in LAD,RAD,LVEDD and LVEF values between programmed group and non-programmed group before and after implantation(P>0.05).Compared with clinical diagnosis results,it was found that the detection rate of atrial fibrillation by permanent pacemaker program control was 97.44%,and the sensitivity of the diagnosis of atrial fibrillation by permanent pacemaker program control was 98.72%.Conclusion:In the diagnosis of atrial fibrillation patients,permanent pacemaker program control can give accurate judgment on the results of ecg examination,which has high clinical application value and is worthy of clinical promotion.