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The square waves and pulses with obvious porter characteristics are inserted into each different adjacent existing dynamic electrocardiogram data to solve the time-consuming problem in the currently used manual input verification method. The standard database files are converted into analog siginals, then output automatically to the ECG acquisition device according to the sequence of the database files in one time. The data recorded in the acquisition equipment is separated according to the interval data protocol, so as to achieve the purpose of rapid digital examination of dynamic electrocardiogram.
Sujet(s)
Humains , Électrocardiographie , Rythme cardiaqueRÉSUMÉ
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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Objective To observe the clinical efficacy of acupoint application plus intake of Chinese herbal medication in treating bradyarrhythmias due to yang deficiency and blood stagnation.Method A total of 110 patients with bradyarrhythmias due to yang deficiency and blood stagnation were randomized into a treatment group and a control group, 55 cases each. The treatment group was intervened by acupoint application at Neiguan (PC 6), Danzhong (CV 17) and Geshu (BL 17) plus Chinese herbal medication, while the control group was treated with oral administration of Theophylline sustained-release tablets. The treatment was given once a day, 2 weeks as a treatment course. The dynamic electrocardiogram (ECG) was observed before the treatment and after 2 treatment courses, and the clinical efficacies were compared between the two groups.Result The total effective rate regarding the Chinese medicine syndromes and signs was 94.5% in the treatment group versus 83.6% in the control group, and the difference was statistically significant (P0.05). The average and lowest heart rates were significantly changed after the treatment in both groups (P<0.05). After the treatment, the average and lowest heart rates in the treatment group were significantly different from those in the control group (P<0.05).Conclusion Acupoint application plus intake of Chinese herbal medication can effectively boost the heart rate of patients with bradyarrhythmias, and improve the discomforts.
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Objective To compare the application value of routine electrocardiogram and dynamic electrocardiogram in the diagnosis of arrhythmia and heart rate variability in children.Methods In our hospital,pediatric arrhythmia patients were given routine electrocardiogram and dynamic electrocardiogram.The relationship between arrhythmia and heart rate variability in children was analyzed.Results Supraventricular tachycardia (13.33%),ventricular tachycardia(5.56%),premature ventricular contraction (21.11%),premature atrial contraction (14.44%),block (12.22%) in the dynamic electrocardiogram were significantly better than the conventional electrocardiogram,and the differences were statistically significant x2=11.93,4.56,9.22,10.74,11.55,all P<0.05).There were significant differences in the heart rate variability between ventricular arrhythmias and non-ventricular arrhythmias in children[(78.85±0.88),(4.68±2.43),(24.78±2.56),(21.66±0.94), t=10.88,11.79,9.84,9.92,all P<0.05].Conclusion Compared with routine electrocardiogram, dynamic electrocardiogram has better diagnostic value for pediatric arrhythmia of ventricular tachycardia.The detection rate of ventricular tachycardia,ventricular tachycardia,premature ventricular contraction,atrial premature contraction,conduction block and other arrhythmias are obviously superior.And dynamic ECG measurement of heart rate variability is helpful to assess the severity of the disease.
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Objective To explore the clinical significance of the heart rate viability decrease in the elderly patients with multiple organ disorders.Methods Two hundred and fifty-nine elderly patients with multiple organ disorders, with underlying diseases as coronary heart disease, hypertension, diabetes, cerebrovascular disease,chronic obstructive pulmonary disease,chronic bronchitis and malignant tumor were enrolled in this study,a retrospective analysis was made on the dynamic electrocardiogram data of the research objects.According to SDNN,123 cases were assigned into the normal HRV group(SDNN≥100ms); 50 cases were divided into the moderately decreased HRV group(50ms≤SDNN<100ms),and 36 cases were divided into the severely decreased HRV group(SDNN<50ms).The average heart rate within 24 hours,clinical diagnosis,and discharge record of the three groups were analyzed.Results As HRV decreased,SDNN decreased gradually (normal HRV group 116(104~131)ms,moderately decreased HRV group 85(67.5~91)ms,severely decreased HRV group 40(35~48)ms),the average heart rate within 24 hours gradually increased(normal HRV group 67(60~76)times/min,moderately decreased HRV group 78(66~84)times/min,severely decreased HRV group 91(80~112)times/min),the differences among the three groups were statistically different(P<0.05).The differences among the groups in the rates of coronary heart disease,hypertension, diabetes,cerebrovascular diseases,chronic bronchitis and chronic heart failure were not statistically significant(P>0.05).The rate of malignant tumor in severely decreased HRV group was 8.3%,significantly higher than that in normal HRV group(0),the difference was statistically significant(P<0.01).In severely decreased HRV group,the rates of chronic obstructive pulmonary disease(25%),chronic renal failure(30.56%),respiratory failure(25%),uremic cardiomyopathy(13.89%),hypoproteinaemia(41.67%)and anemia(41.67%)were significantly higher than those in normal HRV group(1.63%,0.9%,0.81%,0,6.5%,8.94%)and moderately decreased HRV group(7%,11%,2%,3%,11%,11%),the differences were statistically significant(P<0.05) .In moderately decreased HRV group,the rate of chronic renal failure(11%)was higher than that in normal HRV group(0.9%),the difference was statistically significant(P<0.05).Mortality in severely decreased HRV group(41.66%)was significantly higher than that in normal HRV group(2.44%)and moderately decreased HRV group(8%),the difference among the three groups was statistically significant(P<0.05).Conclusion For elderly patients with multiple organ disorders,along with severely decreased HRV,they face the risks of severe imbalances of automatic nervous system,fast heart rate,serious illness,poor nutrition,high mortality.
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Objective:To evaluate the clinical value of combined detection of ischemia modified albumin(IMA), N-terminal pro brain natriuretic peptide(NT-proBNP) and dynamicelectrocardiogram(DEG) in the diagnosis of silent myocardial ischemia.Methods: IMA, NT-proBNP and DEG of 114 patients with silent myocardial ischemia who were suspected coronary heart disease were detected, and then these results were compared and analyzed with the results of coronary angiography(CAG).Results: In 114 patients with suspected coronary heart disease, 68 cases(59.65％)were positive as the results of CAG. And there were 60 cases were positive as the results of IMA detection, and the specificity and sensitivity of IMA compared with CAG were 82.61％ and 88.24％, respectively. There were 63 cases were positive as the results of NT-proBNP, and the specificity and sensitivity of NT-proBNP compared with CAG were 80.43％ and 92.64％, respectively. There were 57 cases were positive as the results of DEG, and the specificity and sensitivity of DEG compared with CAG were 86.96％ and 83.82％, respectively. While there were 66 cases were positive as the combined detection of the three methods, and specificity and sensitivity of the combined detection compared with CAG were 95.65％ and 97.06％, respectively. Therefore, the specificity and sensitivity of combined detection were significantly higher than that of alone detection of IMA, NT-proBNP and DEG (F=140.637,F=255.467,P<0.05).Conclusion: The comprehensive analysis for the combined detections of IMA, NT-proBNP and DEG can increase both of the specificity and sensitivity of diagnosis, and it can be used as a important screening method for earlier finding silent myocardial.
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Objective To investigate the characteristics and clinical value of dynamic electrocardiogram in the treatment of patients with congestive heart failure and atrial arrhythmia.Methods A total of 226 congestive heart failure patients were taken into this research.124 congestive heart failure and atrial arrhythmia patients were divided into OSG group,102 congestive heart failure patients were divided into CTG group.24 -hour Holter monitoring was examined in both groups with ATA including AFR,AFL,ATC and PAC by dynamic electrocardiogram made in Mei Gaoyi medical equipment company.Results The ATA was (824.6 ±108.2)times(compared with the control group, t =9.054,P =0.019)in 124cases of the OSG group,including ATC (80.4 ±25.8)cases (compared with the control group,P =0.021,t =8.934).duration time (25.4 ±9.7)s,AFL (26.8 ±7.1 )cases(compared with the control group,P =0.014,t =9.162).duration time (13.5 ±5.8)s,AFR (97.5 ±51.3)times (compared with the control group,t =9.314,P =0.009).duration time (70.1 ±18.5)s,PAC (41.9 ±14.3)cases (compared with the control group,t =8.796,P =0.026).duration time (34.8 ±11.2)s.The ATA was (102.6 ±59.3)times in 102cases of the CTG group,including ATC (69.5 ±19.4)cases,duration time(5.7 ±1.3)s,AFL(8.5 ±2.6)cases,duration time (2.6 ±0.9)s,AFR (27.6 ±12.5)times,duration time,PAC(24.8 ±10.4)cases,duration time(19.6 ±7.9)s, which was significantly different with the CTG group(t =8.796,P <0.05).Conclusion CHF patients are probable to be complicated with ATA.The DCG examination in CHF patients is conducive to improve the effect of treatment and limit chances of sudden death,which is worthy of promotion.
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Objective To investigate the clinical value of the 24 hour dynamic electrocardiogram diagnosis of the car-diogenic syncope patients. Methods To carry out 24 hour Holter monitoring electrocardiogram for the 118 patients with unexplained syncope, amaurosis, and then to record the ECG conditions at the onset of the illness. Results Thirty-nine cases were with syncope, and 93 cases with arrhythmias, only 6 cases without arrhythmias in the syncope group, 19 cases without arrhythmias in the absence of syncope group. The difference was statistically significant (P<0.05). R-R interval between the two different types of arrhythmia of patients had significant difference (P<0.05). Conclusion To carry out Holter monitoring electrocardiogram for patients with cardiogenic syncope can effectively diagnose the specific etiology.
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Objective To investigate the effect of Sangi Tonglero decoction on dynamic electrocardiogram and clinical results, in order to improve the level of clinical treatment. Method 110 Patients with variant angina pectoris in February 2010 to February 2013 were selected and divided randomly into two groups. 55 patients in control group were given amlodipine treatment , the other in observation group were added Sangi Tonglero decoction beside amlodipine treatment. The differences in electrocardiogram and clinical effects between two groups after treatment were compared. Results The clinical results of dynamic electrocardiogram and angina were showed that the efficiency rate and total efficiency rate in observation group were significantly higher than that in control group(P<0.05). The difference of lipid levels, blood rheology indicators between two groups after treatment were statistically significant (P<0.05). Conclusion Dynamic electrocardiogram is a preferred method of checking variant angina pectoris , and Sangi Tonglero decoction can significantly improve the therapeutic effect .
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Objective To study of the influential factors of dynamic electrocardiogram (DCG)changes after intensity modulated radiation therapy(IMRT) for the lung cancer and breast cancer .Methods IMRT was delivered to 43 patients with lung cancer and 39 patients with breast cancer ,and they were installed DCG before and after the therapy .The associations of clinical and DVH fac‐tors with DCG changed after IMRT were analyzed .Results 32 patients have abnormal DCG after IMRT (39% ) ,the clinical data and physical factors were analyzed by Logistic regression ,gender(OR=1 .52 ,P22% (OR=1 .15 ,P<0 .05) were the independent influencing factors for abnormal DCG .Conclusion The rate of abnormal DCG is low after IMRT for the lung cancer and breast cancer ,and gender and heart V40 were the independent influencing factors for abnormal DCG .
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Objectives To evaluate the clinical value of heart rate variability (HRV) analysis in school-age healthy chil-dren with functional ST-T changes in electrocardiogram (ECG). Methods In 143 school-age children (50 cases of functional ST-T changes, 43 cases of myocarditis children with ST-T change, 50 cases of healthy controls without ST-T changes), HRV time domain value was measured in three groups with 24 dynamic electrocardiogram. Results Compared with healthy controls, PNN50, rMSSD and SDSD were decreased while the heart rate, SDNN and SDANN were increased in children with functional ST-T changes (P all<0.05). Meanwhile, compared with children with functional ST-T changes and healthy controls, the heart rate was increased while PNN50, rMSSD, SDSD, SDNN and SDANN were decreased in the myocarditis children with ST-T change (P<0.05). Conclusions The autonomic nervous system of school-age children is not stable. The functional ST-T changes are related with the imbalance between sympathetic and vagus nerve activities. HRV analysis has important diagnostic signifi-cance in the functional ST-T changes.
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Objective To investigate and compare the clinical values of routine electrocardiogram and dynamic electrocardiogram in arrhythmia in coronary heart disease diagnosis.Methods 73 patients with coronary heart disease were collected and monitored by routine electrocardiogram and dynamic electrocardiogram,and two groups were e stablished including control group using routine electrocardiogram and observation group using dynamic electrocardiogram.The positive diagnosis rate and the specific diagnosis diresults of arrhythmia in coronary heart disease of both groups were compared.Results The positive diagnosis rate of arrhythmia in coronary heart disease of observation group(75.3％ ) was significantly higher than that of control group(54.8％ ) ( x2 =6.78,P ＜0.05).And the positive diagnosis rate of the observation group was also significantly higher than that of the control group in ventricular premature beats two,triple law,pairs of premature ventricular contractions,atrial premature beats two,triple law,atrial premature beats in pairs,atrioventricular block and paroxysmal ventricular tachycardia( all P ＜ 0.05 ).Conclusion Compared with routine electrocardiogram,the dynamic electrocardiogram in anrnythmia in coronary heart disease diagnosis could obtain higher positive diagnosis rate,and it is worthy of clinical application.
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ObjectiveTo evaluate the value of 24 h dynamic electrocardiogram (DCG) and treadmill exercise testing(TET) in diagnosing coronary heart disease(CHD),and analyze relevant index between coronary arteriography(CAG) and treadmill exercise testing.MethodsOne hundred and forty-nine borderline cases of coronary heart disease were enrolled.Every patient was examined by DCG,TET,and CAG,compared the diagnostic value of TET combined with DCG and TET or DCG alone,and record the increased heart rate during the first minute( △ HRl min) of TET and systolic blood pressure(SBP) recovery.The patients were divided into a CHD group and a non-CHD group according to the results of coronary angiography.ResultsThe sensitivity rate was 78.57％ and specific rate was 70.77％ by means of TET.The sensitivity rate was 61.90％ and specific rate was 66.15％ by means of DCG.The sensitivity rate was 95.23％ ,specific rate was 55.38％,positive predictive value was 73.39％ and negative predictive value was 90.00％ by parallel way of DCG and TET,its sensitivity rate (95.23％) and negative predictive value (90.00％ ) were more than those of DCG or TET alone.The sensitivity rate was 52.38％,specific rate was 95.38％,positive predictive value was 93.62％ and negative predictive value was 60.78％ by serial way of DCG and TET,its specific rate (95.38％) and positive predictive value (93.62％ ) were more than those of DCG or TET alone.The number of men in the CHD group was higher than the number of women.Ratio of systolic blood pressure recovery(rSBPR) in the CHD group was significantly higher than that in the non-CHD group ( P ＜ 0.01 ).Conclusion It can obviously enhance the sensitivity rate and specific rate if combined TET with DCG.Patients with CHD have a delayed decline in SBP during recovery which can be one of the indexes to estimate the extent of myocardial ischemia and coronary artery lesion.
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Objective To investigate the relationship between day and night regularity of asymptomatic ventricular presystole (VPS) and the activity of autonomic nervous system and its clinical significance Methods Thirty children with the absence of underlying organic heart disease were examined with 24 hour dynamic electrocardiogram (DCG), the function of autonomic nervous system and ventricular late potentials (VLP) Results The rate (43%, 13/30) was the day type VPS, 12 out of the 13 resulted from increased activity of sympathetic nerve The rate (30%, 10/30) was the night type VPS, all of them resulted from the activity of the vagus nerve enhanced There was a positive correlation between VPS frequency of day type and heart rate ( r =0 67, P
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A dynamic electrocardiogram record system based on MSP430 SCM is developed in this paper. MSP430 SCM has ultra-low power consumption and a high integration level. The gathered ECG data are stored on a CF card. With low power consumption and being portable, the system is especially suitable for the occasion with the battery as power supply.
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Objective To explore the clinical features and prognosis of arrhythmia in newborn infants.Methods Eighty children with arrhythmia were diagnosed by physical examination and electrocardiogram monitoring in author's hospital from Jan.2004 to Dec.2006.Their clinical features and 24-hour dynamic electrocardiogram were analyzed at the acute stage and followed up.Results Out of 80 cases of arrhythimics,52 cases were boys and 28 cases were girls,with an average age of 4 days on diagnosis of arrhythmias.Forty-five neonates presented with supraventricular arrhythmia,accounting for 56.3%.Their clinical presentations were atypical,and the hypoxia,infection,electrolyte disturbances and metabolic disorders were the main causes of the arrhythmias.After supportive and anti-arrhythmia treatment,18 cases of arrhythmias disappeared of 25 children with premature atrial beats;10 cases of 21 children with premature ventricular beats were cured,2 cases of 4 children with ventricular tachycardia,1 case died;2 cases of 3 children with supraventricular tachycardia didn't occure;3 cases of 5 with atrio-ventricular block were cured.The prognosis was better in supraventricular arrhythmias than that in ventricular and other arrhythmias at discharge.At the follow-up of(1.2?0.7)years,there were no differences in rates of recovery between supraventricular arrhythmias and ventricular arrhythmias.Conclusions Supraventricular arrhythmia was the most common type of arrhythmias in neonates.Most of the arrhythmia in neonates might be functional and could recover without treatment.Supraventricular arrhythmia usually had better prognosis in acute period.Only a few neonates with severe arrhythmia need anti-arrhythmias treatment.