Dynamic electrocardiogram characteristics and prognosis of atrial fibrillation complicated with long R-R interval

Yuan Chao; Fang Dongping; Li Guo; Li Yufeng; Wang Xi; Quan Wei

doi:10.3760/cma.j.issn.1673-4777.2016.11.003

Abstract：Objective To investigate dynamic electrocardiogram characteristics and prognosis in patients with atrial fibrillation complicated with long R-R interval.Methods Totally 115 patients in Beijing Anzhen Hospital,Capital Medical University from August 2015 to December 2015 were enrolled.The dynamic electrocardiogram examination revealed atrial fibrillation with long R-R interval (＞ 2 s).Age and long R-R interval distribution were analyzed.According to the occurrence time of long R-R interval,all patients were divided into sleep related group and non-sleep related group.In sleep related group,R-R interval only occurred between 21:00-6:00;in non-sleep related group,R-R interval occurred anytime.Electrocardiogram characteristics and follow-up data were analyzed between groups.Results Long R-R interval could occur in elderly patients with atrial fibrillation,especially between 21:00-6:00.The lowest ventricular rate,the highest ventricular rate,average ventricular rate and times of long R-R interval had significant differences between sleep related group (53 cases) and non-sleep related group (62 cases) (P ＜ 0.05).In sleep related groups,no patient had amaurosis syncope symptom;17 patients got cardioversion and 16 cases among them showed normal dynamic cardiogram performances;1 case was diagnosed of first-degree atrioventricular block;12 patients showed no long R-R interval.In non-sleep related group,amaurosis syncope occurred to 2 patients and they got recovery after artificial pacemaker implantation in hospital;3 patients had second-and third-degree atrioventricular block after cardioversion;1 patient still showed long R-R interval.Conclusion Atrial fibrillation patients with long R-R intervals and low heart rates need regular follow-ups.