Analysis Of Dynamic Electrocardiogram And Heart Rate Variability In Heart Failure Patients

ObjectiveObserve cardiac arrhythmias in heart failure patients by dynamic electrocardiogram,to find out the characteristics of HRV time domain,frequency domain and scatter diagram,to summarize the ecg activity change rule of heart failure patients,to research autonomic nerve change rule of different heart function classification,to provide the reference and guidance for the judgment and symptomatic treatment in heart failure patients.MethodsRandomly,take 62 patients conforming to the conditions with heart failure as heart failure group,from the Affiliated Hospital of Shandong University of TCM.According to the NYHA heart function classification,heart failure group is divided into ??? level groups:28 cases,? level group:20 cases,??level group:14 cases.Find another 68 health cases with similar age and gender as the control group.Both groups have no significant differences in age structure and sex ratio,are comparable(P>0.05).Record the general information of patients;the indicators of dynamic electrocardiogram include the average heart rate,conduction block,all kinds of atrial arrhythmia,ventricular arrhythmia(premature beat,premature beat in pairs,tachycardia,etc.),and the number of ST-T change;heart rate variability time domain index(SDNN,SDANN,RMSSD,PNN50,HRV triangular index,etc.);frequency domain index(HF,LF and LF/HF);Lorenz scatter diagram characteristics(shape,length,divergence,etc.).Use dynamic electrocardiograph produced by Shenzhen Boying Medical Instrument Technology Company Limitied,record 22?24h to collect the related indicators of research objects,use SPSS 17.0 software to count and analysis the indicators,intend to analysis the dynamic electrocardiogram and heart rate variability characteristics of patients with heart failure.Results1.The cause analysis of heart failure patients:high blood pressure 40.3%,coronary heart disease 35.5%,chronic kidney disease 29%,dilated myocarditis 22.9%,valvular myocarditis 19.4%.2.The dynamic electrocardiogram analysis and comparison:the average heart rate and the slowest heart rate of heart failure group are both higher than the control group(P<0.05),and have statistical difference.The various cardiac arrhythmias of heart failure group(room early,room rate,conduction block,room early,ventricular tachycardia)and the incidence of ST-T change are significantly higher than control group(P<0.05).3.The HRV linear indicators comparison:the heart failure group SDNN,SDANN and RMSSD,PNN50 and HRV triangular indexes decrease compared with the control group(P<0.05);the HF,LF and LF/HF of heart rate group decrease(P<0.05)compared with the control group.4.The wake-up state and sleeping state linear indexes comparison:in the control group,RMSSD,PNN50 and HF are significantly increased in the wake-up state(P<0.05),LF rises but has no significant differences(P>0.05);compared with the wake-up state,there is no statistical significant differences(P>0.05)of RMSSD,PNN50,HF in the sleeping state heart failure group.5.The Lorenz scatter characteristics comparison:the control group is with comet shape,the heart failure group is with torpedo shape;compared with the control group,the length and the discrete degree of the heart failure group are lower(P<0.05);the length of the scatter diagram is significantly positive correlation(P<0.05)with SDNN,HRV triangular index;the discrete degree of scatter diagram has significant positive correlation(P<0.01)with RMSSD,PNN50,HF.6.Cardiac function ???.?,? level between groups comparison:the patients of cardiac function ???,?,? level with SDNN,SDANN.PNN50,HF,LF,the length of scatter diagram have significant differences(P<0.05);can't consider RMSSD and LF/HF,scatter diagram discrete degree in cardiac function ???,?,? level are statistically different(P>0.05).Conclusions1.The incidence of arrhythmia in patients with heart failure is significantly increased compared with the control group.2.The indicators of heart failure patients with SDNN,RMSSD,PNN50,HF,etc,are significantly lower,indicate the vagus nerve tension reducing and autonomic nerve dysfunction.3.The autonomic nervous circadian rhythm of the heart failure group patients is in disorders,the vagus nerve tension significantly reduces at night.4.Most scatter diagrams of heart failure patients is with torpedo shape,the scatter diagram index is positively correlation with the part of the time domain index,frequency domain index by quantitative analysis.5.The indexes SDNN,PNN50,HF,the length of scatter diagram of HRV are closely related to the cardiac function classification.The worse the cardiac function,the lower the heart rate variability.6.The analysis of time domain index,frequency domain index,combined with scatter diagram could evaluate the degree of autonomic nerve dysfunction in heart failure patients comprehensively.