远程实时心电监测在预测急性心律失常患者心源性猝死中的价值

Value of remote real-time ECG monitor in predicting sudden cardiac death in patients with acute arrhythmia

目的:评价远程实时心电监测在预测急性心律失常患者心源性猝死(SCD)中的价值。方法:选取327例发生急性心律失常患者作为研究对象,所有患者均分别采用远程实时心电监测、24 h动态心电图、常规心电图检测,比较三种检测方法对急性心律失常事件的检出率,QRS、QT、QTc值,预测SCD的准确率。结果:24 h心电图、远程实时心电监测心律失常事件检出率均高于常规心电图(P<0.05)。随访3个月,SCD组患者常规心电图、24 h心电图和远程实时心电监测三种方法检查QRS、QTc值均大于非SCD组;QT值小于非SCD组(P<0.05)。SCD组患者三种方法检查QRS、QT、QTc值差异均有统计学意义(P<0.05),其中QRS、QTc值远程实时心电>24 h心电图>常规心电图,QT值远程实时心电监测<24 h心电图<常规心电图(P<0.05);非SCD组患者三种方法检查QRS、QT、QTc值差异均无统计学意义(P>0.05)。三种心电图监测急性心律失常患者QRS、QT、QTc阳性及三种指标联合检测阳性符合率均有差异,其中远程实时心电>24 h心电图>常规心电图(P<0.05)。结论:远程实时心电监测预测急性心律失常患者SCD发生具有较高的价值。

Objective:To evaluate the value of remote real-time ECG monitor in predicting Death during consensual sex(SCD)in patients with acute arrhythmia.Methods:327 patients with acute arrhythmia diagnosed were selected as the study subjects.All patients were detected by remote real-time ECG monitor,24 h Holter monitor,and ordinary electrocardiogram,respectively.The detection rate of acute arrhythmia events,QRS,QT,and QTc values of the three detection methods were compared,and the accuracy of predicting SCD was estimated.Results:The detection rate of arrhythmia events in 24 h electrocardiogram and remote real-time electrocardiogram monitoring equipment was higher than that in conventional electrocardiogram,with statistical significance(P<0.05).After a 3-month follow-up,the QRS and QTc values of patients in the SCD group were higher than those in the non SCD group using conventional electrocardiogram,24 h electrocardiogram,and remote real-time electrocardiogram monitoring.The QT values were lower than those in the non SCD group(P<0.05).There were statistically significant differences in QRS,QT,and QTc values among patients in the SCD group using three methods(P<0.05).Pairwise comparison between SCD groups showed that the QRS and QTc values of 24 h electrocardiogram and remote real-time electrocardiogram monitoring were higher than those of conventional electrocardiogram,while the QT value was lower than that of conventional electrocardiogram.The QRS and QTc values of the remote real-time electrocardiogram monitoring instrument were higher than those of the 24 h electrocardiogram,while the QT value was lower than that of the 24 h electrocardiogram,with statistical significance(P<0.05).The positive coincidence rate of QRS,QT,QTc,and the combination of the three indicators detected by the remote real-time electrocardiogram monitor was higher than that of the 24 h electrocardiogram and conventional electrocardiogram.The positive coincidence rate of QRS,QT,QTc,and the combination of the three indicators detected by the 24 h electrocardiogram was higher than that of the conventional electrocardiogram(P<0.05).Conclusion:Remote real-time electrocardiogram monitoring has high value in predicting the occurrence of SCD in patients with acute arrhythmia.