{"title":"心房颤动患者二度房室传导阻滞的独立危险因素分析及动态心电图的诊断效果。","authors":"Ping Lu, Xingchun Mo, Xiaojing Yang, Yaoyao Lin","doi":"10.2147/IJGM.S515113","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Exploring the independent risk factors of second-degree atrioventricular block (II AVB) in patients with atrial fibrillation (AF), and to evaluate the clinical value of 24-hour dynamic electrocardiogram (DCG) in its diagnosis.</p><p><strong>Methods: </strong>A prospective cohort study was conducted on 947 patients with AF diagnosed and treated in our hospital from January 1, 2021 to December 31, 2021. These patients were divided into combined group (98 cases) and uncombined group (849 cases) according to whether they were accompanied by. The clinicopathological data of the patients were collected, and Multivariate logistic regression analysis was used to analyze the independent risk factors. Patients in combined group were further evenly divided into the study group (underwent 24-hour DCG) and the control group (underwent routine ECG) based on the detection methods. The diagnostic value was valued and the positive detection rate was calculated by ROC curve.</p><p><strong>Results: </strong>The smoking history, left atrial internal diameter (LAD), R-R interval and ventricular rate of patients in two groups had significant differences (<i>P</i><0.001). Smoking history (HR=1.531, 95% CI 1.150-2.038, <i>P</i><0.001), LAD>35.88 mm (HR=1.941, 95% CI 1.301-2.895, <i>P</i><0.001), R-R interval>2.50 s (HR=2.282, 95% CI 1.231-4.229, <i>P</i>=0.014) were independent risk factors for AF combined with II AVB, while ventricular rate≤70 beats/min (HR=0.506, 95% CI 0.293-0.873, <i>P</i>=0.014) were independent protective factors for AF combined with II AVB. The mean ventricular rate (70.03±5.40 beats/min vs 83.11±8.05 beats/min, <i>P</i><0.001) and R-R interval (2.82±0.26s vs 2.37±0.14s, <i>P</i><0.001) in the study group were longer than the control group. The diagnostic positive rate of DCG (97.96% vs 85.71%, <i>χ</i>²=4.900, <i>P</i>=0.027) was higher than that of conventional ECG.</p><p><strong>Conclusion: </strong>Smoking history, LAD, R-R interval and ventricular rate were influential factors for AF combined with II AVB. 24-h DCG had potential diagnostic value in the occurrence of AF combined with II AVB.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"2487-2495"},"PeriodicalIF":2.1000,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068384/pdf/","citationCount":"0","resultStr":"{\"title\":\"Analysis of the Independent Risk Factors of second-Degree Atrioventricular Block in Patients with Atrial Fibrillation and the Diagnostic Efficacy of Dynamic Electrocardiogram.\",\"authors\":\"Ping Lu, Xingchun Mo, Xiaojing Yang, Yaoyao Lin\",\"doi\":\"10.2147/IJGM.S515113\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Exploring the independent risk factors of second-degree atrioventricular block (II AVB) in patients with atrial fibrillation (AF), and to evaluate the clinical value of 24-hour dynamic electrocardiogram (DCG) in its diagnosis.</p><p><strong>Methods: </strong>A prospective cohort study was conducted on 947 patients with AF diagnosed and treated in our hospital from January 1, 2021 to December 31, 2021. These patients were divided into combined group (98 cases) and uncombined group (849 cases) according to whether they were accompanied by. The clinicopathological data of the patients were collected, and Multivariate logistic regression analysis was used to analyze the independent risk factors. Patients in combined group were further evenly divided into the study group (underwent 24-hour DCG) and the control group (underwent routine ECG) based on the detection methods. The diagnostic value was valued and the positive detection rate was calculated by ROC curve.</p><p><strong>Results: </strong>The smoking history, left atrial internal diameter (LAD), R-R interval and ventricular rate of patients in two groups had significant differences (<i>P</i><0.001). Smoking history (HR=1.531, 95% CI 1.150-2.038, <i>P</i><0.001), LAD>35.88 mm (HR=1.941, 95% CI 1.301-2.895, <i>P</i><0.001), R-R interval>2.50 s (HR=2.282, 95% CI 1.231-4.229, <i>P</i>=0.014) were independent risk factors for AF combined with II AVB, while ventricular rate≤70 beats/min (HR=0.506, 95% CI 0.293-0.873, <i>P</i>=0.014) were independent protective factors for AF combined with II AVB. The mean ventricular rate (70.03±5.40 beats/min vs 83.11±8.05 beats/min, <i>P</i><0.001) and R-R interval (2.82±0.26s vs 2.37±0.14s, <i>P</i><0.001) in the study group were longer than the control group. The diagnostic positive rate of DCG (97.96% vs 85.71%, <i>χ</i>²=4.900, <i>P</i>=0.027) was higher than that of conventional ECG.</p><p><strong>Conclusion: </strong>Smoking history, LAD, R-R interval and ventricular rate were influential factors for AF combined with II AVB. 24-h DCG had potential diagnostic value in the occurrence of AF combined with II AVB.</p>\",\"PeriodicalId\":14131,\"journal\":{\"name\":\"International Journal of General Medicine\",\"volume\":\"18 \",\"pages\":\"2487-2495\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-05-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068384/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of General Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/IJGM.S515113\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of General Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/IJGM.S515113","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
目的：探讨心房颤动（AF）患者发生二度房室传导阻滞（II AVB）的独立危险因素，并评价24小时动态心电图（DCG）对其诊断的临床价值。方法：对2021年1月1日至2021年12月31日在我院诊治的房颤患者947例进行前瞻性队列研究。根据有无伴发病例分为联合组（98例）和非联合组（849例）。收集患者的临床病理资料，采用多因素logistic回归分析独立危险因素。根据检测方法将联合组患者进一步平均分为研究组（24小时DCG）和对照组（常规心电图）。采用ROC曲线计算阳性检出率，评价其诊断价值。结果：两组患者吸烟史、左房内径（LAD）、R-R间期、心室率差异有统计学意义(PP35.88 mm （HR=1.941, 95% CI 1.301 ~ 2.895）、P2.50 s （HR=2.282, 95% CI 1.231 ~ 4.229， P=0.014）是AF合并II型AVB的独立危险因素，而心室率≤70次/min （HR=0.506, 95% CI 0.293 ~ 0.873， P=0.014）是AF合并II型AVB的独立保护因素。平均心室率（70.03±5.40次/min vs 83.11±8.05次/min， PPχ²=4.900，P=0.027）高于常规心电图。结论：吸烟史、LAD、R-R间期和心室率是AF合并II型AVB的影响因素。24h DCG对AF合并II型AVB的发生有潜在的诊断价值。
Analysis of the Independent Risk Factors of second-Degree Atrioventricular Block in Patients with Atrial Fibrillation and the Diagnostic Efficacy of Dynamic Electrocardiogram.
Objective: Exploring the independent risk factors of second-degree atrioventricular block (II AVB) in patients with atrial fibrillation (AF), and to evaluate the clinical value of 24-hour dynamic electrocardiogram (DCG) in its diagnosis.
Methods: A prospective cohort study was conducted on 947 patients with AF diagnosed and treated in our hospital from January 1, 2021 to December 31, 2021. These patients were divided into combined group (98 cases) and uncombined group (849 cases) according to whether they were accompanied by. The clinicopathological data of the patients were collected, and Multivariate logistic regression analysis was used to analyze the independent risk factors. Patients in combined group were further evenly divided into the study group (underwent 24-hour DCG) and the control group (underwent routine ECG) based on the detection methods. The diagnostic value was valued and the positive detection rate was calculated by ROC curve.
Results: The smoking history, left atrial internal diameter (LAD), R-R interval and ventricular rate of patients in two groups had significant differences (P<0.001). Smoking history (HR=1.531, 95% CI 1.150-2.038, P<0.001), LAD>35.88 mm (HR=1.941, 95% CI 1.301-2.895, P<0.001), R-R interval>2.50 s (HR=2.282, 95% CI 1.231-4.229, P=0.014) were independent risk factors for AF combined with II AVB, while ventricular rate≤70 beats/min (HR=0.506, 95% CI 0.293-0.873, P=0.014) were independent protective factors for AF combined with II AVB. The mean ventricular rate (70.03±5.40 beats/min vs 83.11±8.05 beats/min, P<0.001) and R-R interval (2.82±0.26s vs 2.37±0.14s, P<0.001) in the study group were longer than the control group. The diagnostic positive rate of DCG (97.96% vs 85.71%, χ²=4.900, P=0.027) was higher than that of conventional ECG.
Conclusion: Smoking history, LAD, R-R interval and ventricular rate were influential factors for AF combined with II AVB. 24-h DCG had potential diagnostic value in the occurrence of AF combined with II AVB.
期刊介绍：
The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas.
A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal.
As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.
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