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Abstract Objective To discuss the application value of remote realtime ECG monitoring in community medical association.Methods A total of 2 858 patients undergoing remote realtime ECG monitoring were selected from the community medical association of First Affiliated Hospital of Jinan University from May 25, 2015 to June 22, 2016. We statistically counted the detection rate of various types of arrhythmias, early warning rate of malignant arrhythmia, incidence of adverse events, detection rate of patients in accordance with cardiac electrophysiologic surgical indications, and the age and time distribution of detected arrhythmias. Results Among the enrolled patients, we identified sinus bradycardia in 88 cases, atrial tachycardia in 1 050, atrial premature beats in 2 014, atrial flutter in 28, atrial fibrillation in 195, ventricular tachycardia in 131, premature ventricular contraction in 1 530, preexcitation syndrome in 7, left and right bundle branch block separately in 25 and 120 cases, borderline rhythm in 46, and sinus arrest in 7. As far as the early warning of malignant arrhythmia was concerned, ventricular tachycardia occurred in 1 980 cases(69.28%), long RR interval(RR interval>2 s) in 1 258(44.02%), RonT in 304(10.64%), STsegment elevation and depression separately in 1 133(39.64%) and 1 141 cases(39.92%), and suspected myocardial infarction in 32(1.12%). Among adverse events, artifacts appeared in 9 cases(0.31%) and lead fell in 43(1.50%). Among the patients in accordance with cardiac electrophysiologic surgical indications, 41(1.43%) were fit for radiofrequency ablation including 27 with frequent ventricular premature beats, 10 with atrial fibrillation and 4 with preexcitation syndrome while 16(0.56%) were in accordance with indications of cardiac pacemaker implantation. The incidences of arrhythmias such as ventricular tachycardia and sinus arrest, and suspected myocardial infarction significantly increased in patients over 60 years old. The quantity of patients in accordance with surgical indications of pacemaker implantation took on a trend of rectilinear rise with age, and its difference was statistically significant among patients at different ages(P=0.022). Conclusion The detection rate of arrhythmia is relatively high in remote realtime ECG monitoring which could be promoted in diagnosing and screening cardiovascular diseases in the community healthcare as an important method.
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[1] Engel H, Huang JJ, Tsao CK, et al. Remote realtime monitoring of free flaps via smartphone photography and 3G wireless Internet: a prospective study evidencing diagnostic accuracy[J]. Microsurgery, 2011, 31(8):589-595.[2] 顾敏, 顾翔, 何胜虎, 等. 比较远程心电监测与心电图、动态心电图在心律失常及心肌缺血中的诊断价值[J]. 江苏实用心电学杂志, 2013, 22(2):565-569.[3] 黄维忠, 孔秋燕, 李艳. “扁鹊飞救”系统在边远山区胸痛患者院前急救中的效果观察[J]. 临床医学工程, 2015, 22(10):1285-1286.[4] 刘伟兰. 急性心肌梗死后心律失常的发生时间及护理[J]. 临床医药文献杂志,2015,2(14):2707.[5] 王文, 朱曼璐, 王拥军, 等. 《中国心血管病报告2012》概要[J]. 中国循环杂志, 2013, 28(6):408-412.[6] Conti CR. Is D2B the only metric to determine outcome with STEMI?[J]. JACC Cardiovasc Interv, 2014, 7(3):339.[7] 牛丹丹, 秦红瑞, 吕本艳. 远程心脏监测系统在区域医疗协同服务中的问题分析与对策研究[J]. 中国社会医学杂志, 2013, 30(2):139 -140.[8] Papai G, Racz I, Czuriga D, et al. Transtelephonic electrocardiography in the management of patients with acute coronary syndrome[J]. J Electrocardiol, 2014, 47(3):294-299.[9] 王红宇, 李俊伟, 邸捷, 等. 城乡远程心电监测效果分析[J]. 中西医结合心脑血管病杂志, 2014, 12(4):390-391. |
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