Nghiên cứu đặc điểm rối loạn nhịp tim bằng ghi Holter điện tâm đồ 24h tại khoa tim mạch bệnh viện đa khoa Quảng Ninh từ tháng 7/2011 - 7/2012

Objectives: We had studied and compared the features of cardiac arrhythmias(CAr) of 218 patients(pts) who suffer from CAr in Quang Ninh province Hospital by recording ECG Holter 24hours continuosly, from jully of 2011 to jully of 2012. Methods: Recording continuosly of 24hours ECG Holter for 218 pts, Prospective study, cross sectional descriptive study without control group. Results: 106/218 pts were male (48,6 percent), 112/218 pts were Female(51.4 percent), mean aged in both gender was 59.7 + or - 16.4 years, there were 243 CAr in 218 pts, mean systolic, mean sinual rate was 84.5 + or - 18.4 bpm. 143/218pts (65.6 percent) had previous structural heart disease (PSHD), 75/218pts (34.4 percent) had no PSHD, 86/218 pts (39.4 percent) had previous hypertension, 18/218pts (8.2 percent) just find out CAr when recording ECG Holter but not taking signs of CAr on routin surface ECG recording. Results of ECG Holter analysis was 218 pts with 243 of CAr including: 154/243 (64.6 percent) of CAr was Supraventricular Arrhythmias such as Sinus Bloc was 2.9 percent, Atrial Prematue Beat (APB) was 14.8 percent, Atrial Fibrillation (AF) was 26.7 percent, Atrial Flutter was 5.8 percent, Junctional Arrhythmias was 4.5 percent, Supraventricular Tachycardia (SVT) was 7.0 percent). 71/243 (29.2 percent) of CAr was Ventricular Arrhythmias such as Ventricular Premature Bea (VPB) was 31.2 percent, Non Sustained Ventricular Tachycardia was 1.6 percent, Sustained Ventricular Tachycardia was 0.8 percent. 18/243 (8.2 percent) of CAr was AV Bloc such as First AV Bloc was 2.5 percent, Second AV Bloc was 2.9 percent and Third AV Bloc was 2 percent. Most of CAr such as AF, Atrial Fluter, SVT, Ventricular Tachycardia, the second, third Heart Bloc was in patients who had PSHD such as valvular heart disease, coronary artery disease, myocardiopathy. According to classification of premature beat of Lown.B: 68/218 (31.2) of CAr was VPB, 16 percent of VPB was second degree VPB, 2.8 percent of VPB was third degree VPB, 6.5 percent of VPB was fouth degree VPB. The Right VPB was 79.4 percent and Left VPB was 20.6 percent, Comperare the electrophysiologic features between right VPB with left VPB such as QRS duration, coupling interval had no significantly different in two groups (p 0.05). Conclusions: The common patients aged was over 40 years, there was no different on prevalence ratio (PR) between gender both (male was 48.6 percent, female was 51.4 percent). The PR of CAr of patient has PSHD (65.6 percent) was higher than the PR of CAr of patient do not have PSHD (39.4 percent). The highest PR of CAr was Supraventricular Arrhythmias (63.4 percent), PR of atrial fibrillation was 26.7 percent, The PR of Ventricular arrhythmias (29.2 percent) was lower the PR of supraventricular (63.4 percent). The PR of heart bloc was 7.4 percent. Advantage of ECG Holter in diagnosis of CAr is better than routin ECG recording because only ECG holter can find out transient arrhythmias, but routin ECG recording can not diagnose.