动态心电图评估室性心律失常消融治疗时机的价值

目的 评估动态心电图在室性心律失常消融治疗时机中的应用价值.方法 选取2013年1月至2015年1月在我院治疗的室性心律失常患者212例,按照随机数表法将患者分为A组、B组、C组和D组,每组各53例,其中A组在6~12点进行统计室性期前收缩(PVS)发生数及高危级别PVS发病数及发生率,B组、C组和D组分别在12~18点、18~24点、0~6点进行高危级别PVS发病数及发生率的统计,四组患者在相应时间段实施消融手术后,对患者的手术效果进行统计比较.结果 四个时段PVS发生数中,A组为(3854.36±2915.84)次,B组为(3426.36±2473.47)次,C组为(3083.62±1694.38)次,D组为(2454.33±1427.37)次,A组患者分别与B组、C组、D组患者比较差异均有统计学意义(P<0.05);同时高危级别PVS发病数及发生率结果显示,A组发生率为79.2%,B组为58.5%、C组为28.3%、D组为24.5%,A组患者分别与B组、C组、D组患者比较,差异均有统计学意义(P<0.05);A组、B组、C组和D组手术总有效率分别为81.1%、64.2%、49.1%、47.2%,A组患者分别与B组、C组、D组患者比较,差异均有统计学意义(P<0.05).结论 利用动态心电图评估发现6~12 Am是一天之中发病次数最高的时间段,在这个时间段进行消融手术,可以极大提高心律失常患者射频消融的成功率,减少患者服用药物治疗而带来的不良反应.

Value of dynamic electrocardiogram in evaluating the timing of ablation of ventricular arrhythmias

Objective To explore the value of dynamic electrocardiogram in evaluating the timing of ablation in patients with ventricular arrhythmias. Methods From January 2013 to January 2015, 212 patients with ventricular ar-rhythmias in our hospital were selected and randomly divided into group A (n=53), group B (n=53), group C (n=53), group D (n=53), in which the cases of high-risk ventricular premature contraction (PVS) and the PVS incidence were recorded in 6:00-12:00, 12:00-18:00, 18:00-24:00, 0:00-6:00, respectively. Ablation was performed in the four groups in the corresponding time period, and the effect of surgery was analyzed. Results The number of cases of high-risk ventricular premature contraction (PVS) were (3854.36±2915.84) in group A, (3426.36±2473.47) in group B, (3083.62 ± 1694.38) in group C, (2454.33 ± 1427.37) in group D, with statistically significant difference between group A and group B, C, D (P<0.05). The incidence of high-risk PVS was A was 79.2%in group A, 58.5%in group B, 28.3%in group C, 24.5%in group D, with statistically significant difference between group A and group B, C, D (P<0.05). The total effective rate of the four groups were 81.1%, 64.2%, 49.1%, 47.2%, with statistically significant differ-ence between group A and group B, C, D (P<0.05). Conclusion According to dynamic electrocardiogram evaluation, the number of attack is the highest during 6:00-12:00, and performing ablation in this time period can greatly improve the success rate of radiofrequency ablation and reduce the adverse reactions caused by drugs.