Chen Zongwei, Tan Hong, Liu Xuemei, Tang Minghua
Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, Liaoning, China.
Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023, China.
Emerg Med Int. 2022 Nov 11;2022:3228023. doi: 10.1155/2022/3228023. eCollection 2022.
To investigate the application effect of 24 h dynamic electrocardiogram in the diagnosis of asymptomatic myocardial ischemia with arrhythmia in elderly patients with coronary heart disease.
A total of 206 elderly patients suspected of coronary heart disease (CHD) with asymptomatic myocardial ischemia and arrhythmia were selected as the research subjects. 24 h dynamic electrocardiogram and conventional electrocardiogram examinations were conducted. Coronary angiography was used as the gold standard to observe the performance of the two examination methods in the diagnosis of asymptomatic myocardial ischemia with arrhythmia in elderly patients with CHD.
Coronary angiography showed 174 positive cases and 32 negative cases among the 206 patients. The diagnostic results of a conventional electrocardiogram showed 150 positive cases and 20 negative cases. Its sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 86.21%, 62.50%, 82.52%, 92.59%, and 45.45%, respectively. The diagnostic results of 24 h dynamic electrocardiograms showed 168 positive cases and 29 negative cases. Its sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 96.55%, 96.63%, 95.63%, 98.25%, and 82.86%, respectively. The above results indicated that 24 h dynamic electrocardiogram was significantly better ( < 0.05). The detection rate of arrhythmia types by 24-hour dynamic electrocardiogram was significantly higher than that of conventional electrocardiogram ( < 0.05).
24 h dynamic electrocardiogram is helpful for the diagnosis of asymptomatic myocardial ischemia with arrhythmia in elderly patients with CHD and can improve the detection rate, thereby providing a basis for clinical diagnosis and treatment.
探讨24小时动态心电图在老年冠心病无症状心肌缺血合并心律失常诊断中的应用效果。
选取206例疑似冠心病且有无症状心肌缺血及心律失常的老年患者作为研究对象。进行24小时动态心电图及常规心电图检查。以冠状动脉造影作为金标准,观察两种检查方法在老年冠心病无症状心肌缺血合并心律失常诊断中的表现。
206例患者中冠状动脉造影显示阳性174例,阴性32例。常规心电图诊断结果显示阳性150例,阴性20例。其灵敏度、特异度、准确度、阳性预测值及阴性预测值分别为86.21%、62.50%、82.52%、92.59%及45.45%。24小时动态心电图诊断结果显示阳性168例,阴性29例。其灵敏度、特异度、准确度、阳性预测值及阴性预测值分别为96.55%、96.63%、95.63%、98.25%及82.86%。上述结果表明24小时动态心电图明显更好(P<0.05)。24小时动态心电图对心律失常类型的检出率明显高于常规心电图(P<0.05)。
24小时动态心电图有助于老年冠心病无症状心肌缺血合并心律失常的诊断,可提高检出率,从而为临床诊断和治疗提供依据。