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动态心电图监测在儿科心脏病学中的应用

The Use of Continuous Electrocardiographic Holter Monitoring in Pediatric Cardiology.

作者信息

Begic Zijo, Begic Edin, Mesihovic-Dinarevic Senka, Masic Izet, Pesto Senad, Halimic Mirza, Kadic Almira, Dobraca Amra

机构信息

Pediatric Clinic, UCC Sarajevo, Bosnia and Herzegovina.

Medical and Biological Engineering Society BiH.

出版信息

Acta Inform Med. 2016 Jul 16;24(4):253-256. doi: 10.5455/aim.2016.24.253-256.

Abstract

OBJECTIVE

To show the place and role of continuous electrocardiographic twenty-four-hour ECG monitoring in daily clinical practice of pediatric cardiologists.

METHODS

According to protocol, 2753 patients underwent dynamic continuous ECG Holter monitoring (data collected from the "Register of ECG Holter monitoring" of Pediatric Clinic, UCC Sarajevo in period April 2003- April 2015).

RESULTS

There were 50,5% boys and 49,5% girls, aged from birth to 19 years (1,63% - neonates and infants, 2,6% - toddlers, 9,95% - preschool children, 35,5% - gradeschoolers and 50,3% children in puberty and adolescence). In 68,1% of patients Holter was performed for the first time. Indications for conducting Holter were: arrhythmias in 42,2% cases, precordial pain in 23,5%, suspicion of pre-excitation and/or pre-excitation in 10%, crisis of consciousness in 8%, uncorrected congenital/acquired heart defects in 4,2%, operated heart defects in 3,7%, hypertension in 3,1% cases, control of the pacemaker in 1,63% and other causes in 3,5% cases. Discharge diagnosis after ECG Holter monitoring were: insignificant arrhythmias in 47,1% cases, wandering pacemaker in 21,3%, pre-excitation in 16,2%, benign ventricular premature beats in 6,3%, atrioventricular block in 3%, sinus pause in 2.2% cases and other arrhythmias in 3,5%. In mentioned period 57 cases of Wolf Parkinson White syndrome were registered, in 4,5% of patients antiarrhythmic therapy was administered. Radiofrequent ablation was performed in 23 cases.

CONCLUSION

The development of pediatric cardiac surgery has initiated development of pediatric arrhythmology as imperative segment of pediatric cardiology. Continuous ECG Holter monitoring has become irreplaceable method in everyday diagnostics and therapy of arrhythmias in children.

摘要

目的

展示连续24小时心电图监测在儿科心脏病专家日常临床实践中的地位和作用。

方法

按照方案,2753例患者接受了动态连续心电图Holter监测(数据收集自2003年4月至2015年4月期间萨拉热窝大学临床中心儿科诊所的“心电图Holter监测登记册”)。

结果

患者中男孩占50.5%,女孩占49.5%,年龄从出生至19岁(1.63%为新生儿和婴儿,2.6%为幼儿,9.95%为学龄前儿童,35.5%为小学生,50.3%为青春期儿童)。68.1%的患者首次进行Holter检查。进行Holter检查的指征为:42.2%的病例为心律失常,23.5%为心前区疼痛,10%为怀疑预激和/或预激综合征,8%为意识障碍,4.2%为未纠正的先天性/后天性心脏缺陷,3.7%为已手术的心脏缺陷,3.1%为高血压,1.63%为起搏器控制,3.5%为其他原因。心电图Holter监测后的出院诊断为:47.1%的病例为无意义心律失常,21.3%为游走心律,16.2%为预激综合征,6.3%为良性室性早搏,3%为房室传导阻滞,2.2%为窦性停搏,3.5%为其他心律失常。在上述期间登记了57例预激综合征病例,4.5%的患者接受了抗心律失常治疗。23例患者进行了射频消融。

结论

小儿心脏外科的发展促使小儿心律失常学作为小儿心脏病学的重要组成部分得以发展。连续心电图Holter监测已成为儿童心律失常日常诊断和治疗中不可替代的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8aa4/5037995/fae6b6b9d403/AIM-24-253-g001.jpg

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