实用心电与临床诊疗2025，Vol.34Issue(2)：222-226,240,6.DOI:10.13308/j.issn.2097-5716.2025.02.013
心电瀑布图在快速诊断起搏器自动阈值管理功能中的应用
Application of electrocardiograpic waterfall plot in rapid diagnosis of automatic threshold management function of pacemakers
刘儒 1张芳芳 2郭璐映1
作者信息
- 1. 473000 河南南阳,南阳市中心医院心电图科
- 2. 450014 河南郑州,郑州大学第二附属医院心电图科
- 折叠
摘要
Abstract
Objective To explore the application value of electrocardiographic waterfall plot in the diagnosis of automatic threshold management function of pacemakers.Methods Retrospective analysis was performed on the ambulatory electrocardiography(AECG)of different brands of pacemakers with operational automatic threshold management function.The rule of changes in electrocardiographic waterfall plots was observed,and their characteristics were summarized.Results The AECG waterfall plot with operational automatic threshold management function of pacemakers was featured as follows.(1)Dual chamber pacemaker.① Ventricular automatic threshold management function:atrial pacing spike peak band or P-peak band fractured,approaching R-peak band,with or without synchronous changes of R-and T-peak bands.② Atrial automatic threshold management function:P-peak band fractured,and converted to atrial pacing spike peak band approaching R-peak band;or atrial pacing spike peak band fractured,approaching R-peak band,with or without synchronous changes of R-and T-peak bands.③Key points of making differential diagnosis of atrial and ventricular automatic threshold management functions:during the operation of atrial automatic threshold management function,time scatter plot demonstrated synchronous downward shift or stratification of the pacing layer;during the operation of ventricular automatic threshold management function,time scatter plot showed no change.(2)Ventricular automatic threshold management function of single chamber pacemaker:the phenomenon of dual pacing pulses appeared in the R-peak band,while time scatter plot demonstrated synchronous downward shift or stratification of the pacing layer.Conclusion During the operation of automatic threshold management function of pacemakers,it is recommended to select the leads with greater amplitude of pacing pulse or P-wave,and observe the changes in the colors of pulse spike peak band and P-peak band,and their distance from the R-peak band in electrocardiographic waterfall plot.Clinicians could accordingly make quick diagnosis,and clearly grasp the operation timing and operation rules of automatic threshold management function.Combined with the reverse technology,we could preliminarily determine the pacemaker brand,and understand other functions of pacemakers through the electrocardiographic manifestations during the operation of automatic threshold management function.Meanwhile,time scatter plots could be used to make differentiation of atrial and ventricular automatic threshold management functions.关键词
动态心电图/心电瀑布图/起搏器/自动阈值管理功能Key words
ambulatory electrocardiography/electrocardiographic waterfall plot/pacemaker/automatic threshold management function分类
医药卫生引用本文复制引用
刘儒,张芳芳,郭璐映..心电瀑布图在快速诊断起搏器自动阈值管理功能中的应用[J].实用心电与临床诊疗,2025,34(2):222-226,240,6.
