目的 分析房颤合并长R-R间期(>1.5 s)的动态心电图(DCG)特点,探讨DCG对房颤合并房室传导阻滞的诊断价值.方法将DCG记录到的186例房颤伴长R-R间期者分为睡眠相关组和睡眠无关组,分析平均心室率、长R-R间期昼夜发生频度及伴随症状.结果睡眠无关组患者睡眠及非睡眠时平均心室率均小于睡眠相关组;睡眠无关组长R-R间期、逸搏及逸搏心律发生频率明显高于睡眠相关组;睡眠相关组患者长间歇时不伴黑矇或晕厥,而睡眠无关组患者长间歇时有22例出现黑矇或晕厥,均发生在清醒状态时.结论分析房颤患者DCG长R-R间期发生的频度、时间等特征有助于判断生理性或病理性房室传导阻滞.%Objective To analyse the characteristics of dynamic electrocardiograms (DCG) in long R-R intervals of atrial fibrillation (AF), and explore the role of DCG in the diagnosis of atrioventrieular block (AVB) in AF patients. Methods 186 AF patients with long R-R intervals are divided into two groups: sleep-related group and non-sleep-related group, and analysis is accomplished on the average ventricular rates, frequencies of long R-R intervals, and the accompanying symptoms. Results The average ventricular rates are significantly lower in non-sleep-related group than those in sleep-related group, both during sleeping time and non-sleeping time. The frequencies of long R-R intervals, escape beats and escape rhythms are significantly higher in non-sleep-related group compared with sleep-related group. No amaurosis or syncope occurs in sleep-related group, while 22 of such symptoms happen in non-sleep-related group during non-sleeping time. Conclusion Analysis of characteristics of frequencies and time in long R-R intervals of DCG may be helpful in the judgment of physiological or pathological AVB in AF patients.
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