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目的探讨心房颤动(A f)伴长R-R间期是否合并Ⅱ度房室传导阻滞(Ⅱ°AVB)的诊断。方法选择持续性A f患者89例,连续记录24h动态心电图(DCG),统计1.5秒以上的长R-R间期发生时间及次数。结果89例患者出现≥1.5秒的长R-R间期78例,占87%,以1.5~2.0秒内多见,共1 896次,占72%。次为2.0~3.0秒,共698次,占26%。3.0秒以上21次,占7.6%。其中15例转复后进行随访,13例房室传导正常,1例显示P-R间期延长,达0.22秒;1例在夜间偶见Ⅱ度房室传导阻滞。结论A f伴长R-R间期者不要轻易做出合并Ⅱ°AVB的诊断,可用“心房颤动伴心室长间期并结合临床”表述。
Objective To investigate whether atrial fibrillation (A f) with long R-R interval is associated with second-degree atrioventricular block (Ⅱ ° AVB). Methods 89 patients with persistent A f were selected and 24 hours continuous electrocardiogram (DCG) was recorded. The time and number of long R-R interval more than 1.5 seconds were counted. Results In 89 patients, there were 78 long-term R-R intervals of ≥1.5 seconds, accounting for 87%. The most common were 1.586 seconds, accounting for 72% of the total. Times for 2.0 ~ 3.0 seconds, a total of 698 times, accounting for 26%. 3.0 seconds or more 21 times, accounting for 7.6%. Among them, 15 cases were followed up after conversion, 13 cases atrioventricular conduction was normal, 1 case showed prolonged P-R, reaching 0.22 seconds; 1 case occasionally Ⅱ degree atrioventricular block at night. CONCLUSIONS: Patients with A f with long R-R intervals should not easily make a diagnosis of a second degree of AVB. They may be described as “atrial fibrillation with long ventricular interval combined with clinical”.