便携式心电监测仪在心房颤动高危患者中的临床应用价值
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摘要
目的探讨便携式心电监测仪在心房颤动(房颤)高危患者早期诊断中的应用价值。方法采用随机数字表法将372例有房颤高危因素患者随机分为2组,研究组184例采用便携式心电监测仪进行12个月心电数据采集(每天至少记录Ⅰ导联心电图30s),对照组188例采用12导联心电图进行心电数据采集(每月最少记录1次),以临床确诊房颤作为标准,计算2组房颤检出率。2组确诊房颤的患者均根据CHA2DS2-VASC评分给予抗栓治疗,并对2组所有患者进行临床随访,记录2组主要心脑血管事件。结果研究组房颤检出率为16. 3%,显著高于对照组的8. 5%(P <0. 05);随访过程中,研究组主要心脑血管不良事件发生率为10. 87%,显著低于对照组的19. 68%(P <0. 05)。结论便携式心电监测仪可以提高高危患者房颤的检出率,通过早期诊断作出相应的抗栓治疗,可显著降低患者的主要心脑血管事件发生率。
Objective It is to evaluate the value of portable electrocardiogram monitor in the early diagnosis of high risk patients with atrial fibrillation(AF). Methods 372 patients with high risk factors of atrial fibrillation were randomly divided into 2 groups by random number table method. The ECG data of the study group including 184 cases was collected by portable ECG monitor(I-lead ECG was recorded at least 30 s per day). The ECG data of the control group including 188 cases were collected by 12-lead ECG(recorded at least once in a month). The clinically confirmed atrial fibrillation was used as the standard to calculate the detection rate of atrial fibrillation. The patients with confirmed atrial fibrillation in the two groups were treated with antithrombotic therapy according to the CHA2 DS2-VASC score. All patients in the two groups were followed up clinically,and the major cardiovascular and cerebrovascular events were recorded. Results The detection rate of atrial fibrillation in the study group was 16. 3%,which was significantly higher than that in the control group(8. 5%)(P < 0. 05). During the follow-up period,the incidence of major cardiovascular and cerebrovascular adverse events in the study group was 10. 87%,which was significantly lower than that of the control group. 19. 68%(P < 0. 05).Conclusion Portable ECG monitor can improve the detection rate of atrial fibrillation in high-risk patients,and the corresponding antithrombotic therapy can be significantly reduced by early diagnosis,which can significantly reduce the incidence of major cardiovascular and cerebrovascular events.
Objective It is to evaluate the value of portable electrocardiogram monitor in the early diagnosis of high risk patients with atrial fibrillation(AF). Methods 372 patients with high risk factors of atrial fibrillation were randomly divided into 2 groups by random number table method. The ECG data of the study group including 184 cases was collected by portable ECG monitor(I-lead ECG was recorded at least 30 s per day). The ECG data of the control group including 188 cases were collected by 12-lead ECG(recorded at least once in a month). The clinically confirmed atrial fibrillation was used as the standard to calculate the detection rate of atrial fibrillation. The patients with confirmed atrial fibrillation in the two groups were treated with antithrombotic therapy according to the CHA2 DS2-VASC score. All patients in the two groups were followed up clinically,and the major cardiovascular and cerebrovascular events were recorded. Results The detection rate of atrial fibrillation in the study group was 16. 3%,which was significantly higher than that in the control group(8. 5%)(P < 0. 05). During the follow-up period,the incidence of major cardiovascular and cerebrovascular adverse events in the study group was 10. 87%,which was significantly lower than that of the control group. 19. 68%(P < 0. 05).Conclusion Portable ECG monitor can improve the detection rate of atrial fibrillation in high-risk patients,and the corresponding antithrombotic therapy can be significantly reduced by early diagnosis,which can significantly reduce the incidence of major cardiovascular and cerebrovascular events.
引文
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[11]Bansal A,Kumar S,Bajpai A,et al. Remote health monitoring system for detecting cardiac disorders[J]. IET Syst Biol,2015,9(6):309-314
[12]夏兰,贾晓冬.基于MSP430和SD卡的心电信号采集系统设计[J].现代电子技术,2015,38(21):20-23
[13]王琦,胡磊,邓国兰.远程心电网络实现方法及运行效果评估[J].重庆医学,2016,45(30):4311-4313
[2] Verma A,Jiang CY,Betts TR,et al. Approaches to catheter ablation for persistent atrial fibrillation[J]. N Engl J Med,2015,372(19):1812-1822
[3]汤日波,董建增,尚美生,等.左心房直径对非瓣膜病持续性心房颤动左心房血栓预测价值的研究[J].中华医学杂志,2015,95(14):1083-1087
[4] Liang DP,Lin T,Tilz R,et al. Catheter ablation for the treatment of persistent atrial fibrillation:Maintenance of sinus rhythm with left atrial appendage and coronary sinus isolation after multiple ablation procedures[J]. Heartrhythm Case Rep,2015,241(2):113-118
[5] Sanak D,Hutyra M,Kral M,et al. Paroxysmal atrial fibrillation in young cryptogenic ischemic stroke:A 3-week ECG Holter monitoring study[J]. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub,2015,159(2):283-287
[6] Abdul-Rahim AH,Fulton RL,Frank B,et al. Association of improved outcome in acute ischaemic stroke patients with atrial fibrillation who receive early antithrombotic therapy:analysis from VISTA[J]. Eur J Neurol,2015,22(7):1048-1055
[7] Labombarda F,Hamilton R,Shohoudi A,et al. Increasing Prevalence of Atrial Fibrillation and Permanent Atrial Arrhythmias in Congenital Heart Disease[J]. J Am Coll Cardiol,2017,70(7):857
[8] Silka MJ,Bar-Cohen Y. Prevalence of Atrial Fibrillation and Permanent Atrial Arrhythmias in Congenital Heart Disease:Sequel or Series?[J]. J Am Coll Cardiol,2017,70(7):866-868
[9]强望远,马红京,袁顺英,等.中年急性心肌梗死后恶性室性心律失常与心率变异性及QT间期变异度异常的相关性[J].中国组织工程研究,2015,10(b5):68-69
[10]Chen HL,Liu HW. A remote electrocardiogram monitoring system with good swiftness and high reliabilility[J]. Computers and Electrical Engineering,2016,53(C):191-202
[11]Bansal A,Kumar S,Bajpai A,et al. Remote health monitoring system for detecting cardiac disorders[J]. IET Syst Biol,2015,9(6):309-314
[12]夏兰,贾晓冬.基于MSP430和SD卡的心电信号采集系统设计[J].现代电子技术,2015,38(21):20-23
[13]王琦,胡磊,邓国兰.远程心电网络实现方法及运行效果评估[J].重庆医学,2016,45(30):4311-4313