Objective To analyze the relationship between atrial fibrillation complicating long R-R interval, escape beat and escape heart rhythm and pathological atrioventricular block by dynamic electrocardiography (DCG). Methods 126 patients with atrial fibrillation were divided into group A (being related to sleep) and group B (being not related to sleep) according to the factor whether long R-R interval, escape beat and escape heart rhythm relevant to sleep. All were detected by DCG for 24 hours. Results The cases with1.5～2.0 s long R-R interval, more than 2.0s long R-R interval, escape beat and escape heart rhythm were (26.02±6.03), (7.39±1.05 ) and (6.90±1.28)in group A and (203.05±41.01), (35.48±7.52), (28.10±6.25) in group B respectively. The cases of group B were markedly more than those in group A. Conclusion Those atrial fibrillation complicating long R-R interval, escape bbeat and escape heart rhythm were related to sleep could not be deemed as pathological atrioventricular block, while those were not related to sleep could be considered pathological atrioventricular block.%目的 采用动态心电图分析心房颤动合并长R-R间期(>1.5s)、逸搏及逸搏心律患者是否存在房室阻滞.方法 对126例心房颤动患者进行24h动态心电图检查,根据患者记录的生活日志,按长R-R间期、逸搏及逸搏心律出现的时间是否与睡眠有关,把患者分为A(睡眠有关组)、B(睡眠无关组)两组.结果 A组发生长R-R间期1.5～2.0s,>2.0s及逸搏及逸搏心律人平均数分别为(26.02±6.03)、(7.39±1.05)、(6.90±1.28):B组发生长R-R间期1.5～2.0s,>2.0s及逸搏及逸搏心律人平均数分别为(203.05±41.01)、(35.48±7.52)、(28.10±6.25);B组明显多于A组(P<0.01).结论 房颤伴长R-R间期、逸搏及逸搏心律与睡眠有关时,此现象非病理性房室阻滞;而房颤伴长R-R间期、逸搏及逸搏心律与睡眠无关时,应视为病理性房室阻滞.
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