常规12导联心电图与24 h动态心电图诊断起搏器植入术后起搏功能异常及心律失常的价值

Value of Routine 12-Lead ECG and 24-h Ambulatory ECG on Pacemaker Dysfunction and Arrhythmia Diagnosis After Pacemaker Implantation

目的:探讨常规12导联心电图与24 h动态心电图在起搏器植入术后起搏功能异常及心律失常诊断中的应用价值。方法:选取2020年11月—2021年11月在南华大学附属长沙中心医院行起搏器植入术的患者66例作为研究对象。患者均进行常规12导联心电图检查和24 h动态心电图检查。比较两种检查方法对起搏器功能异常、心律失常的检出率以及心率变异性时域指标。结果:24 h动态心电图检查对心脏起搏器功能异常的总检出率高于常规12导联心电图,差异有统计学意义(P=0.001)。24 h动态心电图检查对心律失常的总检出率高于常规12导联心电图,差异有统计学意义(P=0.008)。24 h动态心电图检查的24 h内所有正常R-R间期标准差、全程5 min时间段R-R间期均值标准差、24 h内相邻正常R-R间期之差均方根值均高于常规12导联心电图,差异有统计学意义(P<0.001)。结论:24 h动态心电图检查对起搏器植入术后起搏功能异常及心律失常的检出率高于常规12导联心电图检查,且在心率变异性诊断中有较高的敏感性,诊断价值较高。

Objective:To explore the application value of routine 12-lead ECG and 24-h ambulatory ECG in the diagnosis of pacemaker dysfunction and arrhythmia after pacemaker implantation.Methods:A total of 66 patients who underwent pacemaker implantation in Changsha Central Hospital Affiliated to University of South China from November 2020 to November 2021 were selected as the study subjects.Routine 12-lead ECG and 24-h ambulatory ECG were performed in all patients.The detection rate of pacemaker dysfunction and arrhythmia,and time domain index of heart rate variability were compared between the two methods.Results:The totaldetection rate ofpacemaker dysfunction by 24-h ambulatory ECG was higher than thatby routine 12-lead ECG,and the difference was statistically significant(P=0.001).The total detection rate of arrhythmia by 24-h ambulatory ECG was higher than that by routine 12-lead ECG,and the difference was statistically significant(P=0.008).The standard deviation of all normal R-R intervals within 24 h,the mean standard deviation of R-R intervals every 5 minutes in the whole process,and the root mean square values of the differences between adjacent normal R-R intervals within 24 h by 24-h ambulatory ECG were higher than those of routine 12-lead ECG,and the difference was statistically significant(P<0.001).Conclusion:Compared with routine 12-lead ECG examination,the 24-h ambulatory ECG has a higher detection rate in the diagnosis of pacemaker dysfunction and arrhythmia after pacemaker implantation,and has a higher sensitivity in the diagnosis of heart rate variability,with high diagnosis value.