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使用可穿戴式心电图贴片设备对心肌梗死后患者心律失常进行监测:前瞻性队列研究

Surveillance of Arrhythmia in Patients After Myocardial Infarction Using Wearable Electrocardiogram Patch Devices: Prospective Cohort Study.

作者信息

Kwun Ju-Seung, Yoon Chang-Hwan, Kim Sun-Hwa, Jeon Ki-Hyun, Kang Si-Hyuck, Lee Wonjae, Youn Tae-Jin, Chae In-Ho

机构信息

Seoul National University Bundang Hospital, Seongnam-Si, Republic of Korea.

出版信息

JMIR Cardio. 2022 Jun 9;6(1):e35615. doi: 10.2196/35615.

Abstract

BACKGROUND

Acute myocardial infarction may be associated with new-onset arrhythmias. Patients with myocardial infarction may manifest serious arrhythmias such as ventricular tachyarrhythmias or atrial fibrillation. Frequent, prolonged electrocardiogram (ECG) monitoring can prevent devastating outcomes caused by these arrhythmias.

OBJECTIVE

We aimed to investigate the incidence of arrhythmias in patients following myocardial infarction using a patch-type device-AT-Patch (ATP-C120; ATsens).

METHODS

This study is a nonrandomized, single-center, prospective cohort study. We evaluated 71 patients who had had a myocardial infarction and had been admitted to our hospital. The ATP-C120 device was attached to the patient for 11 days and analyzed by 2 cardiologists for new-onset arrhythmic events.

RESULTS

One participant was concordantly diagnosed with atrial fibrillation. The cardiologists diagnosed atrial premature beats in 65 (92%) and 60 (85%) of 71 participants, and ventricular premature beats in 38 (54%) and 44 (62%) participants, respectively. Interestingly, 40 (56%) patients showed less than 2 minutes of sustained paroxysmal atrial tachycardia confirmed by both cardiologists. Among participants with atrial tachycardia, the use of β-blockers was significantly lower compared with patients without tachycardia (70% vs 90%, P=.04). However, different dosages of β-blockers did not make a significant difference.

CONCLUSIONS

Wearable ECG monitoring patch devices are easy to apply and can correlate symptoms and ECG rhythm disturbances in patients following myocardial infarction. Further study is necessary regarding clinical implications and appropriate therapies for arrhythmias detected early after myocardial infarction to prevent adverse outcomes.

摘要

背景

急性心肌梗死可能与新发心律失常相关。心肌梗死患者可能出现严重心律失常,如室性快速心律失常或心房颤动。频繁、长时间的心电图(ECG)监测可预防这些心律失常导致的灾难性后果。

目的

我们旨在使用贴片式设备AT-Patch(ATP-C120;ATsens)调查心肌梗死后患者心律失常的发生率。

方法

本研究为非随机、单中心、前瞻性队列研究。我们评估了71例心肌梗死并入住我院的患者。将ATP-C120设备贴于患者身上1​​1天,并由2位心脏病专家分析新发心律失常事件。

结果

一名参与者被一致诊断为心房颤动。心脏病专家分别在71名参与者中的65名(92%)和60名(85%)中诊断出房性早搏,在38名(54%)和44名(62%)参与者中诊断出室性早搏。有趣的是,40名(56%)患者出现了经两位心脏病专家确认的持续时间少于2分钟的阵发性房性心动过速。在房性心动过速参与者中,与无心动过速的患者相比,β受体阻滞剂的使用显著降低(70%对90%,P=0.04)。然而,不同剂量的β受体阻滞剂没有显著差异。

结论

可穿戴式ECG监测贴片设备易于应用,并且可以关联心肌梗死后患者的症状和ECG节律紊乱。对于心肌梗死后早期检测到的心律失常的临床意义和适当治疗,有必要进行进一步研究以预防不良后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e007/9227655/9ffa1d8292b7/cardio_v6i1e35615_fig1.jpg

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