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常规12导联心电图与24h动态心电图对起搏器植入患者心律失常的敏感性和特异性比较

Comparison of sensitivity and specificity between conventional 12 lead electrocardiogram and 24h dynamic electrocardiogram in patients with pacemaker implantation

摘要:

目的 探讨常规12导联心电图与24 h动态心电图对起搏器植入患者心律失常的敏感性和特异性.方法 选取长治医学院附属和济医院心电图室2016年5月至2017年5月检查的起搏器植入手术治疗的65例患者,患者均分别采用常规12导联心电图与24 h动态心电图两种方法进行检查,观察并比较两组患者的心律失常检测结果,以及敏感度、特异度、准确性等相关指标.结果 24 h动态心电图检出心律失常阳性率达96.9%,常规12导联心电图达53.8%,24 h动态心电图高于常规12导联心电图(χ2=5.182,P<0.05);24 h动态心电图的房室传导阻滞、室性早搏早发、房性早搏早发检出率均高于常规12导联心电图,差异有统计学意义(χ2=8.615,P<0.05);24 h动态心电图监测的特异度、敏感度和准确性分别为96.9%、95.4%和95.4%,常规12导联心电图特异度、敏感度和准确性分别为58.5%、61.5%和53.8%,24 h动态心电图优于常规12导联心电图,差异均有统计学意义(均P<0.05).结论 24 h动态心电图对起搏器植入患者的心律失常检出率高于常规12导联心电图,且其准确性、特异性和敏感度较高,安全可靠,值得临床上推广使用.

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abstracts:

Objective To investigate the sensitivity and specificity of conventional 12 lead electrocardiogram(ECG)and 24h dynamic ECG in patients with pacemaker implantation.Methods From May 2016 to May 2017,65 patients with pacemaker implantation in Heji Hospital Affiliated to Changzhi Medical College were selected.All patients were examined by two methods of routine 12 lead ECG and 24h dynamic ECG.The arrhythmia detection results,as well as sensitivity,specificity,accuracy and other indicators were observed and compared in the two groups.Results The positive rate of arrhythmia detected by 24h dynamic ECG was 96.9%,which was higher than 53.8%of the 12 lead ECG,the difference was statistically significant(χ2 =5.182,P <0.05).The detection rates of atrioventricular block,premature ventricular premature beat and premature atrial premature beat in 24h dynamic ECG group were higher than those of routine 12 lead ECG group,the differences were statistically significant(χ2 =8.615,P<0.05).The monitoring specificity,sensitivity and accuracy of 24h dynamic ECG were 96.9%,95.4%and 95.4%,respectively,which were higher than those of the conventional 12 lead ECG(58.5%,61.5%and 53.8%),the differences were statistically significant(all P<0.05).Conclusion The detection rate of arrhythmia in patients with pacemaker implantation by 24 h Holter is higher than that of routine 12 lead ECG,and its accuracy,specificity and sensitivity are higher,and it is safe and reliable,it is worthy of popularizing in the clinic.

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