摘要
目的探讨超长时程动态心电监测技术(Smart Patch)对心房颤动(房颤)的临床诊断价值。方法选取2016年1月1日至2017年7月31日到阜外医院就诊,临床表现为心悸、阵发性心动过速的71例患者,男39例,女32例,年龄21~75岁,平均年龄(49.35±17.27)岁,用Smart Patch记录14d心电数据,同时在第1天做24h动态心电图检查,通过软件回放分析,比较房颤事件的检出率、房颤负荷和房颤类型。结果Smart Patch共诊断房颤患者27例,动态心电图诊断出8例,Smart Patch房颤事件检出率高于动态心电图,差异有统计学意义(38%对11%,P<0.0001)。Smart Patch和动态心电图评价房颤负荷的相关性较好(r=0.79,P<0.0001),但两种设备对房颤的诊断分型有显著影响(kappa=0.18±0.08,P<0.01)。26例(96%)检出房颤的患者改变了临床治疗方案。结论Smart Patch技术能够明显提高房颤的检出率,具有较高的临床诊断价值,从而为患者制定合理的治疗方案提供证据。
Objective To explore the efficacy of the long term dynamic electrocardiogram monitoring device in patients with suspected atrial fibrillation (AF). Ambulatory cardiac rhythm monitoring is a routine part of the management of patients with paroxysmal AF.Current systems are limited by patient convenience and practicality. Methods From 1st January 2016 to 31th March 2017, 71 cases with suspected AF[aged(49.35±17.27)years, 39 males] treated in our hospital were enrolled.We compared the SmartPatch, a single-use, noninvasive waterproof very long-term continuous monitoring patch, with a 24 h Holter monitor in 71 consecutive patients with paroxysmal AF referred for detection of AF. The detection rate, AF burdon and types of AF were also compared. Results A total of 26 and 8 cases were detected as AF using SmartPatch and Holter respectively.The AF detection rate of SmartPatch and Holter was significantly different (37.7% vs.11.6%, P<0.0001). Overall, among the patients with any AF during the study, there was good correlation between the AF burden estimated by the SmartPatch and Holter(r=0.79, P<0.0001). The clinical classification of the AF pattern changed as a result of wearing the SmartPatch in 25 (96%) AF patients, although in general there was agreement between the two devices (kappa=0.18±0.08, P<0.01). Conclusions The SmartPatch allowed significantly longer continuous monitoring than a Holter, resulting in an improvement in the detection of potentially AF and a meaningful change in clinical AF management.
作者
董潇男
唐闽
王倩
张竞涛
吴瑛
孙奇
张澍
Dong Xiaonan;Tang Min;Wang Qian;Zhang Jingtao;Wu Ying;Sun Qi;Zhang Shu(Center of Arrhythmia ,Fuwai Hospital,Chinese Academy Medical Sciences,Peking Union Medical College,Beijing 100037, China)
出处
《中华心律失常学杂志》
2018年第6期498-502,共5页
Chinese Journal of Cardiac Arrhythmias
基金
国家自然科学基金(2018-GZ19).
关键词
心房颤动
心律失常
动态心电监测
Atrial firillation
Arrhythmias
Dynamic electrocardiogram monitoring
