摘要
目的 探讨阵发性心房颤动 (paroxysmalatrialfibrillation ,PAF)发作、持续、终止的节律变化 ,及诱发PAF的可能因素。方法 采用动态心电图 (DCG)检测 ,分析PAF各时段发作、终止的次数和持续时间的节律变化 ;研究PAF发作与窦性心室率、前 5分钟窦性心律的心率变异、房性期前收缩及其配对间期的关系。结果 ①PAF的发作于凌晨 3∶0 0增多 ,4∶0 0～ 6∶0 0达高峰 ,终止与发作的节律变化基本一致 ,持续高峰在 1 1∶0 0～ 1 6∶0 0 ;②PAF发作前心率 <60次 /min者 78例次 (32 .0 9% ) ,伴低频成分 /高频成分 (LF/HF) <1 .5者 68例次 (87.1 8% ) ;心率 >90次 /min者 52例次 (2 1 .3 % ) ,伴LF/HF >2 .0者 43例次 (82 .69% ) ;③诱发PAF的房性期前收缩配对间期及配对间期 <50 0ms者与对照组比较P <0 .0 5 ,<0 .0 1。结论 DCG对分析PAF发作、持续、终止的节律变化 ,PAF发作与窦性心率、自主神经介导、房性期前收缩及配对间期的关系 ,是一项十分有用的检查方法 。
Objective To investigate circadian variation of the onset, maintenance and termination of paroxysmal atrial fibrillation (PAF), possible factors of eliciting PAF. Methods Monitored by dynamic electrocardiogram(DCG), circadian variation of onset and termination incidence and time lasting changes were observed. The study was focused on heart rate(HR) variation of sinus rhythm before 5 minutes attacking, relationship between premature atrial contraction, coupling interval and PAF episodes. Results ①PAF episodes began to increase from 3 Am, became peak from 4 Am to 6 Am . Circadian variation of onset and termination kept the same. Persistent peak was between 11 Am to 4 Pm.②Before PAF attacking, there were 78 episodes, which HR was lower than 60 beats/min( 32.09 %),companied by 68 episodes, which low frequency/high frequency was< 1.5 ( 87.18 %). There were 52 episodes which HR was faster than 90 beats/min( 21.3 %),companied by 43 episodes which low frequency/high frequency was> 2.0 ( 82.69 %).③The coupling interval of premature atrial contractions eliciting PAF compared with coupling interval of less than 500 ms, P< 0.05 ,< 0.01 . Conclusions DCG was very important and valuable in which analysing circadian variation of the onset, maintenance and termination of PAF, studying the relationship among sinus rhythm of PAF attacking and before attacking, autonomic nervous system, premature atrial contractions and coupling interval. It can provide evidence for clinical treatment, such as prediction the incidence of PAF and conversion,et al.
出处
《临床荟萃》
CAS
北大核心
2003年第9期489-492,共4页
Clinical Focus
关键词
心电描记术
便携式
心房颤动
昼夜节津
electrocardiography,ambulatory
atrial fibrillation
circadian rhythm
