心衰合并心房颤动患者动态心电图监测资料分析心律失常特征

N. M. Kulaiets
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摘要

慢性心力衰竭(CHF)是21世纪最重要的医学、经济和社会问题之一,也是全世界发病率和死亡率的主要原因。的目的。研究心力衰竭心房颤动患者动态心电图监测指标、缺血性变化动态、心率、心律变异性指标及血压。材料和方法。对150例45-65岁的患者进行了检查。所有患者分为两组:第一组-伴有窦性心律或心房颤动(AF)的HF患者(永久性或持续性),(n=75)。II组:无心衰合并房颤患者(n=75)。第三组-对照组:36名实际健康的人。所有患者均行临床检查、心电图、超声心动图(ECHOKG)、动态心电图监测(HM ECG)和每日血压监测(DMAT)。研究的结果。检查患者的心电图分析表明存在心律失常,这是CHF的重要危险因素和进展。心电XM结果提示心房颤动同时存在不同级别的室性心律失常。与健康受试者相比,CHF和AF患者的单级室性心动过速(VAS)和高级别室性心动过速(VAS)数量增加的方向可能存在差异。此外,CHF和AF患者的she数量可能低于伴有窦性心律的CHF患者。CHF和AF患者的最大心率、ST段压低、QT间期离散度等指标均显著高于非CHF合并AF患者(p<0.05)。结论:在检查的患者中发现室性心律紊乱,这是慢性心力衰竭患者预后不良的预测因素。慢性心力衰竭和心房颤动患者在最大心率、最大降速、ST段抬高、QT间期离散度、QTc、心肌缺血发作总持续时间增加等方面的升高方向可能与健康受试者存在差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CHARACTERISTICS OF HEART RHYTHM DISORDERS ACCORDING TO THE DATA OF HOLTER ECG MONITORING IN PATIENTS WITH HEART FAILURE AND ATRIAL FIBRILLATION
Chronic heart failure (CHF) is one of the most significant medical, economic and social problems of the 21st century and remains the main cause of morbidity and mortality worldwide.The purpose. To study the indicators of Holter ECG monitoring, the dynamics of ischemic changes, heart rate, indicators of heart rhythm variability and blood pressure in patients with heart failure and atrial fibrillation.Material and methods. 150 patients aged 45-65 were examined. All patients were divided into groups: Group I – patients with HF with sinus rhythm or atrial fibrillation (AF) (permanent or persistent form), (n=75). Group II – patients without HF with AF, (n=75). Group III – control group: 36 practically healthy people. All patients underwent a clinical examination, ECG, echocardiography (ECHOKG), Holter ECG monitoring (HM ECG) and daily BP monitoring (DMAT).Research results. The analysis of the ECG of the examined patients indicates the presence of heart rhythm disorders, which is an important risk factor and progression of CHF. The results of XM ECG indicate the presence of ventricular arrhythmias of various gradations along with AF. There was a probable difference in the direction of an increase in the number of ventricular extrasystoles (VAS), both single and, most importantly, extrasystoles of high gradations, in patients with CHF and AF compared with healthy subjects. In addition, the number of SHEs in patients with CHF and AF was likely lower than in patients with CHF with sinus rhythm. Indicators of maximum heart rate, ST segment depression and QT interval dispersion in patients with CHF and AF were significantly higher (p<0.05) than similar parameters in patients without CHF with AF.Conclusions: Ventricular heart rhythm disturbances were detected in the examined patients, which is a predictor of an unfavorable prognosis in patients with chronic heart failure. There was a probable difference in the direction of increased levels of maximum heart rate, maximum depression, ST segment elevation, dispersion of the QT interval, QTc, an increase in the total duration of episodes of myocardial ischemia, in patients with chronic heart failure and atrial fibrillation in comparison with healthy subjects.
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