中国全科医学 ›› 2018, Vol. 21 ›› Issue (20): 2499-2502.DOI: 10.3969/j.issn.1007-9572.2018.00.156

所属专题: 心血管最新文章合集

• 专题研究 • 上一篇    下一篇

心房颤动患者短联律间期室性期前收缩易发部位研究

熊玉琴1,刘耿星1,林敏1,方丁芬1,黄卫斌2*   

  1. 1.361003福建省厦门市,厦门大学附属第一医院心电功能科 2.361004福建省厦门市,厦门大学附属心血管病医院心内科
    *通信作者:黄卫斌,副教授,主任医师;E-mail:xmhuangbo@163.com
  • 出版日期:2018-07-15 发布日期:2018-07-15

Common Sites of Short-term Interventricular Premature Beats in Patients with Atrial Fibrillation 

  1. 1.Department of Electrocardiogram,the First Affiliated Hospital of Xiamen University,Xiamen 361003,China
    2.Department of Cardiac Internal Medicine,Xiamen Cardiovascular Hospital of Xiamen University,Xiamen 361004,China
    *Corresponding author:HUANG Wei-bin,Associate professor,Chief physician;E-mail:xmhuangbo@163.com
  • Published:2018-07-15 Online:2018-07-15

摘要: 目的 探讨心房颤动患者短联律间期室性期前收缩的发生与心室解剖位置。方法 回顾性分析2016年厦门大学附属第一医院就诊的323例心心房颤动动伴室性期前收缩患者的24 h动态心电图。通过Lorenz散点图测量心房颤动患者室性期前收缩点集中最短联律间期,并采用逆向技术确定该室性期前收缩的起源部位。结果 室性期前收缩起源左、右心室心尖部的联律间期最短,测量值分别为(380±55)、(394±58)ms,二者比较,差异无统计学意义(P>0.05);左心室心尖部短联律间期测量值低于左心室流入道、左心室流出道、右心室流入道、右心室流出道(t=4.89,P<0.01;t=5.61,P<0.01;t=3.90,P<0.01;t=5.99,P<0.01);右心室心尖部短联律间期测量值低于左心室流入道、左心室流出道、右心室流入道、右心室流出道(t=2.18,P=0.03;t=3.09,P<0.01;t=2.07,P=0.04;t=3.11,P<0.01)。结论 心房颤动患者心尖部较易发生短联律间期的室性期前收缩,其可能与病理生理及心尖部的结构和功能有关。

关键词: 心房颤动, 心脏复合征, 早搏, Lorenz散点图, 心电描记术, 便携式

Abstract: Objective To determine the occurrence of short-term interventricular premature beats and ventricular anatomical position in patients with atrial fibrillation (AF).Methods A retrospective analysis of the 24 h dynamic electrocardiograms of 323 patients with AF and ventricular premature beats treated at the First Affiliated Hospital of Xiamen University in 2016 was performed.The Lorenz scatter plot was used to measure the point of the shortest conjugation among the ventricular premature beats in patients with AF,and the origin of the premature ventricular contractions was determined using the reverse technique.Results The measurements of short-term intervals of ventricular premature beats which originated from the left ventricular apex and right ventricular apex were the shortest〔(380 ± 55) ms and (394 ± 58) ms〕,respectively.There was no significant difference between the two groups (P> 0.05).The measurements of short-term intervals of ventricular premature beats was lower in the left ventricular apex than left ventricular inflow tract,left ventricular outflow tract,right ventricular inflow tract,and right ventricular outflow tract(t=4.89,P<0.01;t=5.61,P<0.01;t=3.90,P<0.01;t=5.99,P<0.01,respectively).The measurements of short-term intervals of ventricular premature beats was lower in the right ventricle apex than left ventricular inflow tract,left ventricular outflow tract,right ventricular inflow tract,and right ventricular outflow tract(t=2.18,P=0.03;t=3.09,P<0.01;t=2.07,P=0.04;t=3.11,P<0.01,respectively).Conclusion The apical level in patients with AF is prone to short-term interventricular premature beats,which may be related to pathophysiology,apical structure and function.

Key words: Atrial fibrillation;Cardiac complexes, premature;Lorenz scatter plot;Electrocardiography, ambulatory