摘要
目的分析动态心电图监测传导阻滞及窦房结功能不良患者在起搏器植入后心律失常的发作类型,探究患者与起搏器工作模式的适配关系。方法回顾性分析院内2023年5月至2024年9月92例传导阻滞及窦房结功能异常患者术后动态心电图,按照起搏器治疗适应证分为传导阻滞组与窦房结功能不良组,各46例。比较2组动态心电图检查异常、起搏工作模式、起搏比例、心室起搏、起搏器有关及自身心律失常检出情况。结果2组起搏异常、感知异常发生率、双腔按需起博(DDI)工作模式检出率、起搏比例、伴2∶1阻滞、Ⅲ度房室传导阻滞、文氏传导现象、室性期前收缩、阵发性心房颤动、室性早搏检出率比较差异无统计学意义(χ^(2)=1.105、0.000、0.174、0.383、0.103、0.137、0.000、1.348、0.261、0.000,P>0.05)。相比于比窦房结功能不良组,传导阻滞组心房按需起搏(AAI)工作模式、心室安全起搏、起搏介导性心动过速(PMT)、感知房性心动过速(AT)触发快速心室起搏、频发房性期前收缩、房性心动过速检出率更低,心室按需起搏/心房同步心室起搏(VDD/VAT)工作模式、心室起搏融合波检出率更高(χ^(2)=14.829、4.842、4.039、4.089、6.133、4.449、7.793、4.483,P<0.05)。结论动态心电图可精准检出起搏器植入后传导阻滞及窦房结功能异常患者的心律失常类型,同时结合心律失常发作特点及起搏器功能状态,能有效评估患者心血管事件发生风险,为临床针对不同疾病类型患者制定个性化治疗方案、合理选择起搏器工作模式提供了可靠依据。
Objective To analyze the types of arrhythmia in patients with conduction block and sinoatrial node dysfunction monitored by ambulatory electrocardiogram(AECG)after pacemaker implantation,explore the adaptation relationship between patients and the working mode of pacemakers.Methods The postoperative AECG of 92 patients with conduction block and SA node dysfunction in our hospital from May 2023 to September 2024 was retrospectively analyzed,and they were divided into block group and SA node dysfunction group,46 cases in each,according to the indications for pacemaker treatment.The AECG abnormalities,pacing working mode,pacing ratio,ventricular pacing,pacemaker-related events and spontaneous arrhythmia in the two groups were compared.Results There was no significant difference in pacing abnormalities,incidence of sensory abnormality,DDI working mode detection rate,pacing ratio,2∶1 block,Ⅲdegree at block,Wenckebach conduction phenomenon,premature ventricular complexes(PVCs),paroxysmal atrial fibrillation,and PVC frequency between the two groups(χ^(2)=1.105,0.000,0.174,0.383,0.103,0.137,0.000,1.348,0.261,0.000,P>0.05).Compared with the SA node dysfunction group,the detection rates of AAI working mode,ventricular safety pacing,pacemaker-mediated tachycardia(PMT),sensed atrial tachycardia(AT)triggering rapid ventricular pacing,frequent premature atrial complexes(PACs)and AT were lower in the block group.Ventricular demand pacing/atrial synchronous ventricular pacing(VDD/VAT)working mode and ventricular pacing fusion wave detection rate were higher(χ^(2)=14.829,4.842,4.039,4.089,6.133,4.449,4.792,7.793,P<0.05).Conclusion AECG can accurately detect the types of arrhythmia in patients with conduction block and sinoatrial node dysfunction after pacemaker implantation.Meanwhile,by combining the characteristics of arrhythmia attacks and the functional status of pacemakers,the risk of cardiovascular events in patients can be effectively evaluated,providing a reliable basis for the clinical formulation of personalized treatment plans for patients with different disease types and the reasonable selection of pacemaker working modes.
作者
王珂
李慧
Wang Ke;Li Hui(Department of Cardiac Function,the Fifth Clinical Medical College of Henan University of Chinese Medicine(Zhengzhou People′s Hospital),Zhengzhou 450000,China)
出处
《实用医技杂志》
2025年第8期625-628,共4页
Journal of Practical Medical Techniques
