应用心电瀑布图分析起搏器AV动态调整功能

The application of electrocardiogram waterfall in diagnosis of pacemaker AV dynamic adjustment function diagnostics

目的探讨动态心电图中的心电瀑布图,用于分析诊断起搏器AV动态调整功能的价值。方法回顾性分析植入有AV动态调整功能起搏器患者的动态心电图,观察心电瀑布图变化规律,总结其特征。结果AV动态调整功能表现为:当心房率增快,AV间期缩短,心电瀑布图心房起搏脉冲峰带或P峰带出现断裂,向R峰带漂移,心率减慢,AV间期延长,直至低限频率程控AV间期,心房起搏脉冲峰带或P峰带出现断裂,远离R峰带,恢复至缩短前的位置。结论起搏器开启AV动态调整功能时,选择起搏脉冲或P波振幅较高的导联,观察心电瀑布图上起搏脉冲峰带或P峰带变化及其与R峰带的距离,可以做出快速分析诊断,清晰掌握AV动态调整功能运作特点、持续时间的长短,结合逆向技术,准确判断该功能运行的规律。

Objective To explore the value of electrocardiogram waterfall in rapid diagnosis of pacemaker AV dynamic adjustment function.Methods We retrospectively analyze the pacemaker dynamic ECG with AV dynamic adjustment function,observe the ECG waterfall changes,and summarize its characteristics.Results AV dynamic adjustment function operates as follows,when the atrial rate increases,the AV interval is shortened,the ECG waterfall chart atrial pacing spike band or P peak band is broken,drifting towards the R peak band,the heart rate is slowed,and the AV interval is extended until the low-limit frequency program-controlled AV interval,the atrial pacing spike band or P peak band is broken,away from the R peak band,and returns to the position before shortening.Conclusions When the pacemaker turns on the AV dynamic adjustment function,select the lead with a high pacing pulse or P wave amplitude,observe the change of pulse spike peak band or P peak band on the ECG waterfall chart and its distance from the R peak band,you can make rapid analysis and diagnosis,clearly grasp the operation characteristics and duration of AV dynamic adjustment function,and combine reverse technology to accurately judge the operation law of the function.