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目的采用动态心电图分析心房颤动合并长RR间期(≥1．5s)、逸搏及逸搏心律患者是否存在病理性房室阻滞。方法用动态心电图仪24h记录患者的心电图,根据患者生活记录,把长RR间期、逸搏及逸搏心律出现时间是否与睡眠相关,分为与睡眠相关组(A组)及非睡眠相关组(B组)。结果共106例患者．A组75例(70．8%),B组31(29．2%)。A组和B组发生长RR间期1．5～2．0s、＞2．0s及逸搏及逸搏心律人平均数分别为25．17±9．57、7．21±0．93、6．79±1．23和203．14±39．86、34．79±7．56、27．39±6．13,B组明显多于A组(P＜0．01)。结论心房颤动合并长RR间期、逸搏及逸搏心律与睡眠相关时比率高,为非病理性房室阻滞;而与睡眠无关时应视为病理性房室阻滞。
Objective To analyze whether there is pathological atrioventricular block in patients with atrial fibrillation combined with long RR interval (≥1.5s), aneurysm and escape rhythm by dynamic electrocardiogram. Methods The electrocardiogram was recorded 24h with a Holter monitor. According to the patient’s life records, the long RR interval, esophageal stroke and esophageal arrhythmia were related to sleep, and divided into sleep related group (group A) and non-sleep related group (Group B). Results A total of 106 patients. Group A 75 (70.8%), Group B 31 (29.2%). The long RR interval in group A and group B was 1.5 ~ 2.0s,> 2.0s and the mean number of escape and escape rhythm was 25.17 ± 9.57,7.21 ± 0.93, 6.79 ± 1.23 and 203.14 ± 39.86, 34.79 ± 7.56 and 27.39 ± 6.13, respectively, which were significantly higher in group B than those in group A (P <0.01). Conclusion Atrial fibrillation combined with long RR interval, escape and escape rhythm and sleep-related high rate of non-pathological atrioventricular block; while not related to sleep should be considered as pathological atrioventricular block.