Meilhac B, Fleury G, Heulin A, Le Pailleur C, Vacheron A, Di Matteo J
Arch Mal Coeur Vaiss. 1978 Dec;71(12):1341-6.
Ninety symptomatic patients aged between 16 and 90 years were investigated by ambulatory continuous 24 hour electrocardiography. 75 of these patients underwent endocavitary exploration of atrioventricular conduction and sinus node function within 48 hour of ambulatory electrocardiography. Symptoms occurred during the recording in 30% patients, enabling the mechanism of the malaise to be determined. Every time that abnormalities in the zone surrounding the Tawara node were demonstrated by endocavitary recordings, the 24 hour electrocardiogramme showed the symptoms to be due to other causes than complete heart block. In 70% patients no symptoms were experienced but 58% of them had cardiac arrhythmias and particularly sinus node dysfunction (24 out of 37 patients) on the 24 hour electrocardiogramme. Comparing the results of these two methods of investigation, continuous electrocardiography appears to be a better technique for the diagnosis of sinus node dysfunction but endocavitary study of sinus node function would seem more suited to determine its severity. Endocavitary recordings seem more reliable in the investigation of paroxysmal atrioventricular blocks. These results demonstrate the complementary nature of these two methods in determining the causes of syncope and dizziness.
对90名年龄在16至90岁之间的有症状患者进行了动态连续24小时心电图检查。其中75名患者在动态心电图检查后48小时内接受了房室传导和窦房结功能的心腔内探查。30%的患者在记录过程中出现症状,从而能够确定不适的机制。每当心腔内记录显示希氏束结周围区域异常时,24小时心电图显示症状是由完全性心脏传导阻滞以外的其他原因引起的。70%的患者没有症状,但其中58%在24小时心电图上出现心律失常,尤其是窦房结功能障碍(37名患者中有24名)。比较这两种检查方法的结果,动态心电图似乎是诊断窦房结功能障碍的更好技术,但窦房结功能的心腔内研究似乎更适合确定其严重程度。心腔内记录在阵发性房室传导阻滞的研究中似乎更可靠。这些结果证明了这两种方法在确定晕厥和头晕原因方面的互补性。