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| Characteristic analysis on scatter plot of atrial autonomic rhythm continuously capturing sinus rhythm |
| YANG Wei,JING Yongming,ZHANG Fangfang,LI Shifeng |
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Abstract Objective To explore the advantages of the joint use of three kinds of ECG scatter plots in rapidly analyzing special arrhythmias, and to accumulate experience of complex arrhythmia analysis. Methods Patients with special arrhythmias featured by atrial autonomic rhythm continuously capturing sinus rhythm in Lorenz scatter plot were selected; their time scatter plot and difference scatter plot were jointly analyzed. Based on reversal technique and mathematical model, the characteristics of cardiac cycle and schematic principle were analyzed, and the nature of arrhythmias was clarified. Results The three kinds of ECG scatter plots have their own characteristics. Time scatter plot shows the stratification law of typical atrial premature beats: the purple bottom layer (NS, SS) is compact and dense while the medium layer (NN) and top layer (SN) is relatively sparse; the medium and top layers disappear in parts of time intervals, only leaving purple bottom layer (SS) extending backward. In the Lorenz scatter plot, typical point set of atrial premature beats, and point set before and after premature beats can be observed. However, the point set of sinus rhythm(NNN) along the 1 s line is sparse or absent while a large number of point sets of atrial rhythm (SSS) are overlapped in NNN beneath the 1 s line. It shows the characteristics of atrial autonomic rhythm continuously capturing sinus rhythm. In the difference scatter plot, a large number of point sets of continuously released atrial rhythm (NSSN, SSSN) are distributed at the positive side of y axis while a large number of point sets of atrial rhythm (SSSS) are overlapped in the point set of sinus rhythm (NNNN). From a macroscopic view of scatter plot, atrial rhythm is dominant since its selfdiscipline reaches or slightly exceeds that of sinus rhythm. In the occurrence of intermittent efferent block, sinus rhythm is re-captured by atrial rhythm only after two beats of capture. This is the reason for the absence of point set NNN over the 1 s line, replaced by lower point set SSS. Since the original rhythm of atrial rhythm is disrupted by the two beats of sinus capture, there is no protective afferent block in atrial rhythm of this example, and it is actually atrial autonomic rhythm with increased self-discipline. Conclusion The joint use of three kinds of ECG scatter plots provides a macroscopic view for identifying the nature of special complex arrhythmias. It shows obvious advantages in the rapid analysis of complex arrhythmias.
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. [J]. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2021, 30(6): 448-452. |
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