心电散点图与 24h动态心电图诊断房颤伴二度房室阻滞的应用价值

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Application value of electrocardiogram scatter plot and 24-hourdynamic electrocardiogram in the diagnosis of atrialfibrilationwithsecond-degreeatrioventricularblock ，，. ， ， 473ooo，

【Abstract】Objective To explore the application value of scater plots and 24-hour dynamic electrocardiogram （24-hour AECG）inthediagnosis，atrial fibrilation （AF）withsecond-degreeatrioventricular block（AVB）.Methods A totalof 78patientswithAFwho were admited toourhospital from April 2O21to May 2O24 wereselectedand divided into two groupsbasedonwhether they hadAVB.Twenty-two patientswith AVB were included in the observation group，and 56 patients without AVB were included in the control group.Both groups underwent 24-hour AECGand electrocardiogram scater plot examinations，and the 24 -hour AECG examination resultsand electrocardiogram scater plotcharacteristics were recorded.ResultsThe incidence of escape>2.Os within 24 hours in the observation group was 77%（17/22），and theR-R interval time was （2.84±0.34）s，which was higher than thatof the control group [ 23% （13/56） and （2.42±O.22） s]. The average ventricular rate in the observation group was （63±5） beats per minute，which was lower than that of the control group [（79±8） beats per minute] （ P <0.05）. The observation group's electrocardiogramscater plotshowed a "swet tube shape"，with ascateredO°surface scatter observed from X-Y-Z，resembling a regular hexagon.The number of arrys with continuous RR intervals greater than 1 5OO ms can beestimated.The median number of arrys with AVB occurring within 24 hourswas20.95，while the electrocardiogram scater plot shows a "bouquet shape"or "gyro shape".The O°surface scater observed from X-Y-Z was more concentrated，resembling atriangle，with no selectable scater points.Conclusion24-hour AECG can reflectheartratechanges inpatients withatrialfibrilation，and combined with electrocardiogramscatterplots，itcan quicklyand intuitively determine whether the patient has second-degree AVB，guiding clinical treatment.

【Key Words】Atrial fibrilation;Dynamic electrocardiogram；Atrioventricular block；ECG scatter plot

心房颤动（简称“房颤”是指心房规则有序的电活动丧失，取而代之的为快速无序的颤动波，造成心房有效的收缩功能丧失，影响心房泵血功能，加上房室结对快速心房激动的递减传导，可诱发心室极不规则反应，导致患者出现心功能受损、心室律紊乱、心房附壁血栓形成，是临床常见的心脏病之一[1，2]。（剩余6613字）