|
|
|
| Twenty-four hour ambulatory electrocardiography analysis of 120 atrial fibrillation patients |
| TU Ji |
| (Department of Electrocardiogram, Suizhou Hospital Affiliated to Hubei University of Medicine, Suizhou Central Hospital, Suizhou Hubei 441300, China) |
|
|
|
|
Abstract Objective To analyze the 12 lead ambulatory electrocardiography(AECG) of patients with atrial fibrillation(AF), and to explore the relationship between the concomitant abnormal manifestations and ages, disease diagnosis and organic heart disease, respectively, in order to know about paroxysmal atrial fibrillation(PAF) further. Methods The AECG data of 120 patients were collected who were diagnosed with AF or PAF by Holter examination. Those data were retrospectively analysed and summarized against the background of baseline, according to the concomitant abnormal manifestations during AF recorded by AECG. Results (i) There were 68 out of 120 AF cases complicating various types of ECG abnormalities by Holter examination, with an incidence rate of 56.7%(68/120). The most common ECG abnormalities were rapid ventricular rate and ventricular premature beats, accounting for 30.8%(37/120) and 29.2%(35/120), respectively. ST-T changes, conduction block and long R-R intervals (＞2.0 s) successively took the next places, accounting for 26.7%(32/120), 24.2%(29/120), and 19.2%(23/120) , respectively. Among the AF patients over 65, there were sometimes two or more types of concomitant ECG abnormalities in the same case. (ii) There were 18 out of 120 AF cases diagnosed with PAF, accounting for 15%(18/120), mostly triggered by atrial premature beats. In pulmonary heart disease group， coronary disease group, surgery examination group and rheumatic heart disease group, ventricular premature beat was common, accounting for 45%(5/11)， 50.0%(11/22)，42.9%（2/7） and 30.0%（3/10）, respectively. In hypertension group, ST-T changes were more common, accounting for 44.1%(15/34). Rapid ventricular rate was mostly seen in chest suppressionpalpitation group, hyperthyreosis group and diabetes group, accounting for 38.0%(8/21), 33.3%(1/3), and 22.2%(2/9), respectively. In syncope group, there was one case complicating rapid ventricular rates, and one with long RR intervals (＞2.0 s). The incidence of concomitant AECG abnormality can be as high as 67.4% among patients with organic heart disease. Conclusion Holter can accurately reveal the concomitant AECG abnormalities among AF patients, which may be two or even more types in the AF patients complicating organic heart disease and(or) the ones over 65, and determine the initiating factors and site of PAF.
|
|
|
|
|
|
| [1] Kannel WB，Abbott RD，Savage DD，et al. Coronary heart disease and atrial fibrillation:the Framingham Study[J]. Am Heart J，1983，106（2）：389-396.[2] Manolio TA，Furberg CD，Rautaharju PM，et al. Cardiac arrhythmias on 24h ambulatory electrocardiography in older women and men:the Cardiovascular Health Study[J].J Am Coll Cardiol，1994，23(4):916-925.[3] Fuster V，Rydén LE，Asinger RW，et al. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: executive summary a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for practice guidelines and policy conferences (committee to develop guidelines for the management of patients with atrial fibrillation) developed in collaboration with the north American society of pacing and electrophysiology [J]. Circulation，2001，104(17):2118-2150.[4] Bakeeva LE，Barskov IV，Egorov MV，et al. Mitochondriatargeted plastoquinone derivatives as tools to interrupt execution of the aging program.2.Treatment of some ROSand agerelated diseases (heart arrhythmia, heart infarctions, kidney ischemia, and stroke)[J]. Biochemistry (Mosc)，2008，73(12)：1288-1299.[5] BAI Huaishan，HOU Yanfeng，LI Yi，et al.Using Dynamic electrocardiogram to analyze the electrocardiograph triggering of paroxysmal atrial fibrillation[J].Chinese Journal of Cardiovascular Medicine，2006，11(6): 454-456.[6] 郭继鸿，胡大一.中国心律学[M].北京：人民卫生出版社，2011：473-474.[7] 邹月娥，欧阳清彦，涂爱兰.阵发性房颤心电触发因素及其部位诊断中动态心电图的应用价值分析[J].现代预防医学，2012，39（16）：4312-4313.[8] 卢喜烈.301临床心电图学[M].北京：科学技术文献出版社，2010：753-754. |
|
|
|
2015, Vol. 24 
