1.400038 重庆,陆军军医大学(第三军医大学)军事预防医学系军队流行病学教研室
2.400032 重庆,沙坪坝区双碑社区卫生服务中心
3.561113 贵阳,贵州医科大学公共卫生与健康学院环境污染与疾病监控教育部重点实验
4.400039 重庆,九龙坡区疾病预防控制中心
5.401120 重庆,重庆医科大学附属第三医院心血管疾病中心
Received:06 October 2023,
Revised:2023-12-05,
Published:15 June 2024
移动端阅览
Zhiquan YUAN, Na WU, Huiyan JIAO, et al. Monitoring of wearable long-range ambulatory electrocardiographic monitor for a community-based homebound elderly population[J]. Journal of Army Medical University, 2024, 46(11): 1316-1322.
Zhiquan YUAN, Na WU, Huiyan JIAO, et al. Monitoring of wearable long-range ambulatory electrocardiographic monitor for a community-based homebound elderly population[J]. Journal of Army Medical University, 2024, 46(11): 1316-1322. DOI: 10.16016/j.2097-0927.202310006.
目的
2
对社区居家老年人群进行动态心电监测结果调查,并探讨穿戴式长程动态心电监测仪在社区居家老年人群中的适用性。
方法
2
于2021年11月至2023年6月在重庆市沙坪坝区双碑社区招募老年志愿者,采用单导联穿戴式动态心电记录仪进行连续7 d的心电监测,描述设备穿戴中的不良反应、可接受度、监测时长、心电监测结果。严重心律失常事件包含频发房早、心房扑动、心房颤动(房颤)、频发室早、RR间期≥5 s心律失常事件。
结果
2
共416例研究对象纳入分析,年龄(71.2±6.6)岁,男性150人(36.1%);384例(92.3%)研究对象完成7 d佩戴,佩戴时长(159.2±29.4)h。179例(48.5%)研究对象穿戴心电监测设备无任何不适,175例(47.4%)佩戴部位皮肤瘙痒。监测结果显示,常见的心律失常依次为房性早搏(97.1%)、室性早搏(93.3%)、房性心动过速(84.6%)、心动过缓(46.6%)、频发房性早搏(15.1%)、室性心动过速(13.2%)、长RR间期(11.8%)等。其中29.1%的研究对象有严重心律失常事件,高龄(≥70岁)、有既往心脏疾病史的人群某些严重心律失常事件检出率较高。
结论
2
社区居家老年人群常见心律失常检出率较高,监测周期7 d可能较合适。
Objective
2
To investigate the results of ambulatory electrocardiographic (ECG) monitoring in a community-based homebound elderly population and to explore the applicability of wearable long-range ambulatory ECG monitor for them.
Methods
2
Elderly volunteers were recruited in Shuangbei Community
Shapingba District
Chongqing
from November 2021 to June 2023. A single-lead wearable ambulatory ECG recorder was applied to them to obtain ECG for 7 consecutive days. The adverse reactions
acceptability
monitoring duration
and arrhythmia detection rate during the wearing were described and recorded. Serious arrhythmic events included frequent atrial premature
atrial flutter
atrial fibrillation (AF)
frequent ventricular premature
and RR intervals ≥5 s.
Results
2
There were 416 individuals enrolled
with a mean age of 71.2±6.6 years
and a male percentage of 36.1% (150 men). Finally
384 (92.3%) participants completed the wearing of the ECG monitor for 7 d
with an average time of 159.2±29.4 h. There were 179 participants (48.5%) reporting no discomfort during wearing
and 175 ones (47.4%) feeling itchy at the wearing site. The monitoring results showed that the common arrhythmias were atrial premature contractions (97.1%)
premature ventricular contractions (93.3%)
atrial tachycardia (84.6%)
bradycardia (46.6%)
frequent atrial premature contractions (15.1%)
ventricular tachycardia (13.2%)
and long RR interval (11.8%). Among them
29.1% of the participants experienced serious arrhythmic events
and the detection rate of certain serious arrhythmic events was comparatively higher in the individuals ≥70 years of age and those with history of previous cardiac disease.
Conclusion
2
The detection rate of common arrhythmias is quite high in the community-based homebound elderly population. A 7-day long-range ambulatory ECG monitoring may be appropriate.
AL-KHATIB S M, STEVENSON W G, ACKERMAN M J, et al . Correction to: 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines and the Heart Rhythm Society[J ] . Circulation, 2018, 138(13): e272-e391. DOI: 10.1161/cir.0000000000000614.
DU X, GUO L Z, XIA S, et al . Atrial fibrillation prevalence, awareness and management in a nationwide survey of adults in China[J ] . Heart, 2021, 107: 535-541. DOI: 10.1136/heartjnl-2020-317915.
WILLEMS S, BOROF K, BRANDES A, et al . Systematic, early rhythm control strategy for atrial fibrillation in patients with or without symptoms: the EAST-AFNET 4 trial[J ] . Eur Heart J, 2021, 43: 1219-1230. DOI: 10.1093/eurheartj/ehab593.
VARMA N, CYGANKIEWICZ I, TURAKHIA M P, et al . 2021 ISHNE/HRS/EHRA/APHRS expert collaborative statement on mHealth in arrhythmia management: digital medical tools for heart rhythm professionals: from the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia-Pacific Heart Rhythm Society[J ] . Circ Arrhythm Electrophysiol, 2021, 14(2): e009204. DOI: 10.1161/CIRCEP.120.009204.
尹彦琳. 动态心电图的规范化[J]. 江苏实用心电学杂志, 2013, 22(3): 634-642. DOI: 10.13308/j.issn.1008-0740.2013.03.004.
YIN Y L. Standardization of dynamic electrocardiogram[J]. J Jiangsu Pract Electrocardiol, 2013, 22(3): 634-642. DOI: 10.13308/j.issn.1008-0740.2013.03.004.
全军心血管专业委员会心脏无创检测学组《心电图诊断术语规范化中国专家共识》编写专家组, 郭继鸿, 王思让, 等. 心电图诊断术语规范化中国专家共识(2019)[J]. 实用心电学杂志, 2019, 28(3): 161-165.
Woiting Expert Group for Chinese Expert Consensus Statement on the Standardization of Electrocardiography Diagnostic T ermiology of Noninvasive Cardiac Testing Group of the Military Cardiovascular Professional Committee, Task Force on GUO J H, WANG S R, et al . Chinese expert consensus statement on the standardization of electrocardiography diagnostic terminology 2019[J ] . J Pract Electrocardiol, 2019, 28(3): 161-165.
ARNAR D O, MAIRESSE G H, BORIANI G, et al . Management of asymptomatic arrhythmias: a European Heart Rhythm Association(EHRA) consensus document, endorsed by the Heart Failure Association(HFA), Heart Rhythm Society(HRS), Asia Pacific Heart Rhythm Society(APHRS), Cardiac Arrhythmia Society of Southern Africa(CASSA), and Latin America Heart Rhythm Society( LAHRS)[J ] . EP Eur, 2019, 21(6): 844-845. DOI: 10.1093/europace/euz046.
PHAM M, MENGISTU Y, DO H M, et al . Cloud-based smart home environment(CoSHE) for home healthcare[C ] //2016 IEEE International Conference on Automation Science and Engineering(CASE). IEEE, 2016: 483-488. DOI: 10.1109/COASE.2016.7743444 http://dx.doi.org/10.1109/COASE.2016.7743444 ..
胡凯, 陈颖敏, 卜军, 等. Smartpatch长时程动态心电图监测对心律失常的诊断价值[J]. 中国心脏起搏与心电生理杂志, 2019, 33(1): 17-20. DOI: 10.13333/j.cnki.cjcpe.2019.01.004.
HU K, CHEN Y M, BU J, et al . The diagnostic value of long-term dynamic electrocardiogram monitor Smartpatch for arrhythmia[J ] . Chin J Card Pacing Electrophysiol, 2019, 33(1): 17-20. DOI: 10.13333/j.cnki.cjcpe.2019.01.004.
SANA F, ISSELBACHER E M, SINGH J P, et al . Wearable devices for ambulatory cardiac monitoring: JACC state-of-the-art review[J ] . J Am Coll Cardiol, 2020, 75(13): 1582-1592. DOI: 10.1016/j.jacc.2020.01.046.
HERMANS A N L, GAWALKO M, PLUYMAEKERS N A H A, et al . Long-term intermittent versus short continuous heart rhythm monitoring for the detection of atrial fibrillation recurrences after catheter ablation[J ] . Int J Cardiol, 2021, 329: 1 05-112. DOI: 10.1016/j.ijcard.2020.12.077.
余新艳, 赵晓晔, 杨建云, 等. 可穿戴单导联远程心电监测设备结合散点图在院外应用的分析[J]. 中国循环杂志, 2021, 36(11): 1096-1100. DOI: 10.3969/j.issn.1000-3614.2021.11.006.
YU X Y, ZHAO X Y, YANG J Y, et al . Analysis of the out-of-hospital application of wearable single lead remote electrocardiogram monitoring equipment combined with scatter plot[J ] . Chin Circ J, 2021, 36(11): 1096-1100. DOI: 10.3969/j.issn.1000-3614.2021.11.006.
STEINBERG J S, VARMA N, CYGANKIEWICZ I, et al . 2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry[J ] . Ann Noninvasive Electrocardiol, 2017, 22(3): e12447. DOI: 10.1111/anec.12447.
中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 早搏基层诊疗指南(2019年)[J]. 中华全科医师杂志, 2020, 19(7): 561-566. DOI: 10.3760/cma.j.cn114798-20200507-00532.
Chinese Medical Association, Chinese Medical Journals Publishing House, Chinese Society of General Practice, et al . Guideline for primary care of extrasystole(2019)[J ] . Chin J General Practice, 2020, 19(7): 561-566. DOI: 10.3760/cma.j.cn114798-20200507-00532.
MANNINA C, JIN Z Z, MATSUMOTO K, et al . Frequency of cardiac arrhythmias in older adults: findings from the Subclinical Atrial Fibrillation and Risk of Ischemic Stroke(SAFARIS) study[J ] . Int J Cardiol, 2021, 337: 64-70. DOI: 10.1016/j.ijcard.2021.05.006.
BINICI Z, INTZILAKIS T, NIELSEN O W, et al . Excessive supraventricular ectopic activity and increased risk of atrial fibrillation and stroke[J ] . Circulation, 2010, 121(17): 1904-1911. DOI: 10.1161/CIRCULATIONAHA.109.874982.
MARCUS G M. Evaluation and management of premature ventricular complexes[J]. Circulation, 2020, 141(17): 1404-1418. DOI: 10.1161/circulationaha.119.042434.
KORNEJ J, BÖRSCHEL C S, BENJAMIN E J, et al . Epidemiology of atrial fibrillation in the 21st century: novel methods and new insights[J ] . Circ Res, 2020, 127(1): 4-20. DOI: 10.1161/CIRCRESAHA.120.316340.
GLADSTONE D J, WACHTER R, SCHMALSTIEG-BAHR K, et al . Screening for atrial fibrillation in the older population: a randomized clinical trial[J ] . JAMA Cardiol, 2021, 6(5): 558-567. DOI: 10.1001/jamacardio.2021.0038.
CARRINGTON M, PROVIDÊNCIA R, CHAHAL C A A, et al . Clinical applications of heart rhythm monitoring tools in symptomatic patients and for screening in high-risk groups[J ] . Europace, 2022, 24(11): 1721-1729. DOI: 10.1093/europace/euac088.
申伟娜, 王银平, 赵文娇. 超长时程动态心电监测在老年房颤中的应用[J]. 临床心电学杂志, 2021, 30(6): 422-424. DOI: 10.3969/j.issn.1005-0272.2021.06.006.
SHEN W N, WANG Y P, ZHAO W J. Application of extra-long term ambulatory ECG monitoring in elderly patients with atrial fibrillation[J]. J Clin Electrocardiol, 2021, 30(6): 422-424. DOI: 10.3969/j.issn.1005-0272.2021.06.006.
郭光耀, 张郁澜, 张志国, 等. 穿戴式远程实时心电监测仪与传统动态心电图在居家老年心血管疾病患者中的监测效果[J]. 医疗装备, 2022, 35(15): 9-12. DOI: 10.3969/j.issn.1002-2376.2022.15.003.
GUO G Y, ZHANG Y L, ZHANG Z G, et al . Monitoring effects between wearable remote real-time electrocardiogram monitor and traditional dynamic electrocardiogram in aged and In-home patients with cardiovascular disease[J ] . Chin J Med Device, 2022, 35(15): 9-12. DOI: 10.3969/j.issn.1002-2376.2022.15.003.
KIM J Y, OH I Y, LEE H, et al . The efficacy of detecting arrhythmia is higher with 7-day continuous electrocardiographic patch monitoring than with 24-h Holter monitoring[J ] . J Arrhythm, 2023, 39(3): 422-429. DOI: 10.1002/joa3.12865.
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