目的探讨动态心电图对心房颤动合并病理性二度房室阻滞的诊断价值。方法将持续性心房颤动患者(房颤伴三度房室阻滞者除外)动态心电图检查记录到的长R-R间期、逸搏及逸搏心律有无伴随头晕、黑曚、晕厥等相关症状,分为有相关症状组(A组)和无相关症状组(B组),每组患者各30例,统计两组2.0s以上长R-R间期、逸搏(及逸搏心律)发生的时间及频率、房颤时最快心室率及24h平均心室率并进行比较分析。结果 A组发生长R-R间期、逸搏(及逸搏心律)的频率明显高于B组(P<0.01),A组日间与夜间长R-R间期、逸搏(及逸博心律)的发生率无明显差异(P>0.05),B组夜间长R-R间期、逸搏(及逸博心律)的发生率明显高于日间(P<0.01),A组最快心室率及24h平均心室率均明显慢于B组(P<0.01)。结论动态心电图有助于我们掌握持续性房颤患者长R-R间期、逸搏及逸搏心律发生的时间、频度及有无相关伴随症状和24h内整体心室率情况,除外生理性因素的干扰可考虑做出心房颤动合并病理性二度房室阻滞的诊断或提示,便于临床医生能尽早干预和处理,从而改善患者的症状和预后。 Objective To investigate the diagnostic value of ambulatory electrocardiogram for atrial fibrillation complicated with pathologic second degree atrioventricular block. Methods Patients with persistent atrial fibrillation (atrial fibrillation with third-degree atrioventricular block excluded) recorded by the dynamic electrocardiogram long RR interval, escape and escape rhythm associated with dizziness, black flushes, syncope and other related symptoms, Divided into related symptoms group (group A) and no relevant symptoms group (group B), each group of 30 patients, the two groups were more than 2.0s RR interval, Yat stroke (and escape rhythm) occurred in time and Frequency, the fastest ventricular rate in AF and 24h mean ventricular rate and comparative analysis. Results The frequency of RR and esophageal arrhythmia in group A was significantly higher than that in group B (P <0.01). In group A, the RR and YAC (P> 0.05). The incidence of long RR interval and esophageal stroke (YPC) in group B at night was significantly higher than that at daytime (P <0.01). The fastest ventricular rate in group A and the average of 24h Ventricular rate were significantly slower than the B group (P <0.01). Conclusions Holter monitoring helps us understand the long RR interval, the time and frequency of rhythm and escape rhythm of patients with persistent AF, and the associated symptoms with or without 24 h and the overall ventricular rate within 24h, except for the interference of physiological factors Can be considered to make a diagnosis of atrial fibrillation or pathologic second degree of atrial block diagnosis or prompt for clinicians to intervention and treatment as soon as possible to improve the patient’s symptoms and prognosis.