心房颤动的Lorenz-RR散点图分析

来源 :中国心脏起搏与心电生理杂志 | 被引量 : 0次 | 上传用户:cmccetehi
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目的分析阵发性心房颤动(简称房颤)与持续性房颤伴不同心律失常的Lorenz-RR散点图特征,探讨Lorenz-RR散点图对房颤伴不同心律失常的诊断价值。方法对88例阵发性房颤与持续性房颤患者的24h动态心电图,回顾性分析其Lorenz-RR散点图特征。比较阵发性房颤组与持续性房颤组的平均、最快、最慢心室率及房室结功能有效不应期(AVNFRP)界线斜率。比较持续性房颤伴差传组与持续性房颤伴室性早搏(简称室早)组的平均、最快、最慢心室率及AVNFRP界线斜率。结果房颤Lorenz-RR散点图表现为扇形,当合并其他心律失常时,表现为扇形与其特征性心律失常散点图共存。阵发性房颤表现为扇形与棒球拍形图形共存。房颤伴室性早搏及房颤伴室内差异性传导有不同的散点图特征。阵发性房颤组最快心室率较持续性房颤组明显增快(P<0.01)。房颤伴差传组平均心室率、最快心室率明显快于房颤伴室早组(P<0.01)。结论阵发性房颤与房颤合并不同心律失常具有不同的散点图特征。Lorenz-RR散点图对鉴别房颤伴短联律间期室早与房颤伴差传具有独特的优势。 Objective To analyze the Lorenz-RR scattergram of patients with paroxysmal atrial fibrillation (AF) and persistent atrial fibrillation (AF) with different arrhythmias and investigate the diagnostic value of Lorenz-RR scattergram in patients with atrial fibrillation with different arrhythmias. Methods 88 patients with paroxysmal atrial fibrillation and persistent atrial fibrillation 24h dynamic electrocardiogram, retrospective analysis of its Lorenz-RR scatter plot characteristics. The mean, the fastest, the slowest ventricular rate and the AVNFRP boundary slope of patients with paroxysmal atrial fibrillation and persistent atrial fibrillation were compared. The mean, the fastest, the slowest ventricular rate and AVNFRP boundary slope were compared between patients with persistent atrial fibrillation and those with metastatic disease and those with persistent atrial fibrillation and ventricular premature beats. Results The Lorenz-RR scatter plot of atrial fibrillation was fan-shaped, and when combined with other arrhythmias, the fan showed a coexistence with its characteristic arrhythmia scatter plot. Paroxysmal atrial fibrillation showed fan-shaped and baseball bat shape coexistence. Atrial fibrillation with premature ventricular contractions and atrial fibrillation with different indoor transmission of different scatter plot characteristics. The fastest ventricular rate in paroxysmal atrial fibrillation group was significantly higher than that in persistent atrial fibrillation group (P <0.01). The mean ventricular rate and the fastest ventricular rate were significantly faster in patients with atrial fibrillation with dyspnea than those with atrial fibrillation (P <0.01). Conclusions There are different scatter features of paroxysmal atrial fibrillation and atrial fibrillation with different arrhythmia. The Lorenz-RR scattergram has unique advantages in discriminating atrial fibrillation with a short course of interventricular septum and atrial fibrillation.
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