Bartůnĕk P, Gorican K, Zapletalová J, Kotrlíková E, Mrázek V
IV interní klinika I. LF UK a VFN, Praha.
Cas Lek Cesk. 1996 Jun 12;135(12):385-8.
The problem of impaired cardiac rhythm is in recent years in the foreground of the interest of cardiologists. This was influenced not only by the conclusions of the CAST study which changed the therapeutic pattern used for some years but above all the diagnostic pitfalls of impaired rhythm as regards detection and identification. The objective of the present study was to provide evidence of the advantages and usefulness of the method of telephone transmission of the electrocardiogram within the complex of other diagnostic procedures.
The group was formed by 251 patients, incl. 186 men and 65 women, average age 51.7 years (range 19-85 years). The transmission of the ECG by phone was implemented by the system TESLAR (VUIS-CVUT) which comprises recording units and a terminal with a graphic outlet. A total of 3,727 electrocardiographic tracings were assembled. During their analysis the arithmetic mean was used as the characteristic of the position of the group or groups on the scale, the error of the mean expressing the ratio of the standard deviation to the number of cases. In nominal variables most frequently percentage expression was used, frequently with a confidence interval obtained from tables. Evidence of the usefulness of the method is the high rate of detected arrhythmias within emergency calls (88.5%), as compared with normal calls (10.6%) where the yield is close to that of Holter monitoring, however, with the advantage of time ad libitum and thus also a higher yield.
The presentation of long-term experience with electrocardiograms by telephone confirms unequivocally the assumption that the method extends existing diagnostic possibilities in short-term, symptomatic, but sporadic arrhythmias, that it makes possible dispensarization of risk patients as well as patients with permanent pacemakers and that it improves the tactics of antiarrhythmic treatment.
近年来,心脏节律受损问题一直是心脏病专家关注的焦点。这不仅受到CAST研究结论的影响,该研究改变了多年来使用的治疗模式,更重要的是,心脏节律受损在检测和识别方面存在诊断陷阱。本研究的目的是在其他诊断程序的综合体系中,提供心电图电话传输方法的优势和实用性的证据。
该组由251名患者组成,其中包括186名男性和65名女性,平均年龄51.7岁(范围19 - 85岁)。通过TESLAR系统(VUIS - CVUT)实现心电图的电话传输,该系统包括记录单元和带有图形输出的终端。共收集了3727份心电图记录。在分析过程中,算术平均值被用作该组或多组在量表上位置的特征,平均值的误差表示标准差与病例数的比率。对于名义变量,最常使用百分比表示,通常带有从表格中获得的置信区间。该方法实用性的证据是,与普通电话(10.6%)相比,紧急呼叫中检测到心律失常的比率较高(88.5%),普通电话的检出率接近动态心电图监测,但具有随时可用的优势,因此检出率也更高。
通过电话进行心电图的长期经验展示明确证实了以下假设:该方法扩展了现有诊断可能性,可用于短期、有症状但偶发的心律失常,使风险患者以及永久性起搏器患者无需频繁就医,并改善了抗心律失常治疗策略。