CAJ | 학술논문

目的：探讨缓慢型心房颤动（ Af ）伴发长R-R间期在静态心电图（ ECG ）中发生率及意义。方法回顾性分析66例静态ECG表现为缓慢型Af的患者，根据有无伴随头晕、黑矇、晕厥等相关症状，分为有相关症状组A组37例，无相关症状组B组29例；根据年龄分为高龄组（≥80岁）42例，非高龄组（＜80岁）24例。观察缓慢型Af伴发长R-R间期发生率并进行比较分析。结果 A组发生长R-R间期30例，占81．08％，B组发生6例，占20．69％。 A组发生率高于B组（χ2＝10．87，P＜0．05）；高龄组发生29例，占69．05％，非高龄组发生7例，占29．17％，高龄组发生率高于非高龄组（χ2＝11．63，P＜0．05）。结论静态ECG检查可以及时发现缓慢型Af伴发长R-R间期，对伴发头晕、黑矇、晕厥等相关症状患者和高龄患者应高度重视，适当延长ECG描记时间，详细描述长R-R的长度，慎重Af合并二度房室传导阻滞诊断，为临床医生尽早干预和处理提供依据，从而改善患者的症状和预后。
목적：탐토완만형심방전동（ Af ）반발장R-R간기재정태심전도（ ECG ）중발생솔급의의。방법회고성분석66례정태ECG표현위완만형Af적환자，근거유무반수두훈、흑몽、훈궐등상관증상，분위유상관증상조A조37례，무상관증상조B조29례；근거년령분위고령조（≥80세）42례，비고령조（＜80세）24례。관찰완만형Af반발장R-R간기발생솔병진행비교분석。결과 A조발생장R-R간기30례，점81．08％，B조발생6례，점20．69％。 A조발생솔고우B조（χ2＝10．87，P＜0．05）；고령조발생29례，점69．05％，비고령조발생7례，점29．17％，고령조발생솔고우비고령조（χ2＝11．63，P＜0．05）。결론정태ECG검사가이급시발현완만형Af반발장R-R간기，대반발두훈、흑몽、훈궐등상관증상환자화고령환자응고도중시，괄당연장ECG묘기시간，상세묘술장R-R적장도，신중Af합병이도방실전도조체진단，위림상의생진조간예화처리제공의거，종이개선환자적증상화예후。
Objective To investigate the clinical significance and the regulation of occurrence of long R-R interval in static electrocardiogram ( ECG) among atrial fibrillation ( AF) patients with slow ventricular rate (<60 /min).Methods 66 static ECG cases of atrial fibrillation ( AF) patients with slow ventricular rate were retrospectively analyzed in the study .The cases were divided into two groups by two different means .Group A:37 cases with dizziness , syncope and other related symptoms; Group B: 29 cases without above-mentioned symptoms.By the age of patients, these cases were divided into Aged Group (≥80 years old,42 cases) and Yonger Group ( <80 years old, 24 cases).The patterns of Escape beats occurrences (and its rate) in these caseswere observed , and results were compared among groups .Results Group A had 30 cases with long R-R interval, accounting for 81.08%, which is higher than Group B (6 cases, 20.69%), the difference is of statistical significance(χ2 =10.87,P <0.05).Accordingly, the Aged Group had 29 cases with long R-R interval, accounting for 69.05%, which is higher than the rate of long R-R interval occurrence in Younger Group (7 cases, 29.17%), the difference is of statistical significance (χ2 =11.63,P<0.05).Conclusions Cases of Slow AF ( ventricular rate <60 /min ) with long R-R interval can be discovered in time by static ECG examination, escape beats and its rate can also be observed .Special attention should be paid to aged patients more than 80 years old ands low AF patients with dizziness , syncope and other related symptoms .An extension of the ECG recording time and detailed description of the length of long R-R intervals are highly recommended for the reference of clinical diagnosis and early clinical intervention , so as to improve the prognosis .A diagnosis of AF combined with Second-degree atrioventricular block should be make very cautiously .