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目的:了解阵发性心房颤动伴心室长间歇的临床意义。方法:对动态心电图记录到的11例窦性心律伴阵发性心房颤动的患者伴发心室长间歇进行分析。男性10例,女性1例。年龄50岁～77岁,平均(66.6±7.48)岁,特发性心房颤动6例,冠心痛5例,脑梗塞1例。结果:11例共发生特发性心房颤动570阵,大于2.0s的长间歇141次,长间歇在2.0s～2.7s。时间分布为白天16次,夜间125次,心房颤动发作前后的窦性PR间期在0.15s～0.20s之间者6例,一度房室阻滞3例,二度Ⅰ型房室阻滞1例。P波时限<0.11s的5例,≥0.11 s的6例。24h最高心率77bpm～175bpm,平均(126.5±23.2)bpm,最低心率35bpm～47bpm,平均(42.2±2.92)bpm,平均心率53bpm～90bpm(68.6±11.12) bpm。结论:阵发性心房颤动合并心室长间歇多出现于夜间睡眠时,心肌缺血、房内阻滞、房室阻滞等是其可能机制。
Objective: To understand the clinical significance of paroxysmal atrial fibrillation with long ventricular septum. Methods: 11 cases of sinus rhythm with paroxysmal atrial fibrillation recorded by Holter were analyzed with long ventricular interval. 10 males and 1 females. Aged 50 years to 77 years, mean (66.6 ± 7.48) years, idiopathic atrial fibrillation in 6 cases, 5 cases of coronary heart disease, cerebral infarction in 1 case. Results: A total of 570 patients with idiopathic atrial fibrillation occurred in 11 patients. 141 long-duration intermittent episodes longer than 2.0s and 2.0s ~ 2.7s long intermittent episodes. Time distribution of 16 times during the day and night 125 times before and after the onset of atrial fibrillation sinus PR interval between 0.15s ~ 0.20s in 6 cases, once atrioventricular block in 3 cases, second degree type Ⅰ atrioventricular block 1 example. 5 cases of P wave duration <0.11s, 6 cases ≥0.11s. The maximum heart rate of 24h was 77bpm ~ 175bpm, with an average of (126.5 ± 23.2) bpm. The minimum heart rate was 35bpm ~ 47bpm with an average of (42.2 ± 2.92) bpm and an average heart rate of 53bpm ~ 90bpm (68.6 ± 11.12) bpm. Conclusions: Paroxysmal atrial fibrillation combined with long ventricular septal intermittent appear in nighttime sleep, myocardial ischemia, atrioventricular block, and atrioventricular block are the possible mechanisms.