平板运动试验中发生的心律失常分析

Analysis of the characteristics of arrhythmia induced by treadmill exercise test

关键词:  运动试验  心律失常  心肌缺血  冠状动脉造影

Key words:  treadmill exercise test  arrhythmia  cardiac ischemia  coronary angiography

摘要:

［目的］探讨平板运动试验中发生心律失常的原因及意义。［方法］对400例患者依据平板运动试验及冠状动脉造影结果分为试验阳性者和阴性组，比较两组心律失常发生率及严重心律失常发生率，运动试验采用Bruce极量或次极量方案。［结果］400例运动试验诱发心律失常共156例，发生率为39%，运动试验阳性组心律失常发生率（60%）高于阴性组（40%）；运动试验阳性组严重心律失常发生率（22%）与阴性组（3%）比较差异有显著性意义，P<0.05；冠状动脉造影阳性组心律失常发生率（72%）高于阴性组（28%）；冠状动脉造影阳性组严重心律失常发生率（24%）与阴性组（2%）比较差异有显著性意义，P<0.05。［结论］运动试验可辅助临床对冠心病的诊断，运动试验阳性组发生心律失常比较常见，运动中、运动后发生的心律失常可能与心肌缺血等因素有关。

Abstract:

［Objective］To explore the occurrence and the characteristics of arrhythmia induced by treadmill exercise test.［Methods］Based on 400 cases of both treadmill test and coronary angiography,patients were divided into positive and negative groups.Occurrence rates of arrhythmia and serious arrhythmia were analyzed between two groups.Sub-maximal or maximal dose of standard Bruce program was applied to analyze the arrhythmias.［Results］One hundred and fifty-six of 400 cases were found arrhythmia and occurrence rate of arrhythmia was 39%.The incidence of arrhythmia in positive treadmill exercise test patients (60%) was greater than that of negative patients (40%).The incidence of serious arrhythmia in positive treadmill exercise test patients (22%) was significantly greater than that of negative patients (3%,P<0.05).The incidence of arrhythmia in positive coronary angiography patients (72%) was greater than that of negative patients (28%).The incidence of serious arrhythmia in positive coronary angiography patients (24%) was significantly greater than that of negative patients (2%,P<0.05).［Conclusion］Treadmill exercise test helps to diagnose coronary heart disease and occurrence of arrhythmia in positive treadmill exercise test is common.It may be related to cardiac ischemia during the test and after the test.