| ObjectiveSinoatrial node function [1,2] including self-discipline and conductivity. Sinoatrial node conduction test including indirect sinoatrial node conduction time, sinoatrial node conduction time directly measuring the [3]. Esophageal atrial cardiac check at present the most reliable, but because of its certain traumatic, exist in for atrial fibrillation (af) in the esophageal lesions and contraindication, the lack of conditions is difficult to carry out medical units. How to get support from a more simple and noninvasive way method for the determination of sinoatrial node function, is an important clinical subject. The purpose of this paper is to study room sex arrhythmia after the termination of compensatory pause and united law of interphase and the sinoatrial node function of inner link, to explore the dynamic electrocardiogram (ecg) for diagnosis of the sinoatrial node function.MethodsCollected in the esophagus atrial adjustable stroke cases of sinoatrial node dysfunction, and obstacles, including low function to eliminate the vagus nerve, atropine test by inspectors. Corresponding dynamic electrocardiogram zhong sex arrhythmia after the termination of compensatory pause, measuring the sinoatrial node function changes of time, area of time period between different league law after premature beat four regions of the sinoatrial node response. Count data using 2 test. Compare two methods of examination of diagnostic test (two types of count data) are not at the same time, the nature of using matching chi-square test. Evaluation to evaluate the diagnostic methods (HOLTER examination) and the gold standard (TEAP) to check the consistency of the probe, USES the consistency check (Kappa test) [49]. Kappa acuity 0.75 are found to be in good consistency; 0.75> Kappa acuity 0.4 both consistency in general; Poor Kappa<0.4 both consistency. Period between the two independent variables-united law (X) and compensatory pause (Y) using the rank correlation analysis (rank correlation) [50]. Analysis results reference:|r|< 0.3, known as the weak correlation,0.3 or less|r|< 0.5, called low correlation,0.5 or less|r|< 0.8, called (moderate) correlated,0.8 or less|r|< 1, known as highly correlated. Inspection standard for:P 0.05 or less have statistical significance.ResultsSimultaneously TEAP and HOLTER examination, a total of 64 patients in TEAP check,53 cases detected sinoatrial node dysfunction,11 cases belong to the negative result; And HOLTER examination,55 patients with sinus node function change time>0.32 s standard diagnosis of positive cases,9 cases were negative results; Diagnostic sensitivity analysis according to 90.57% and 36.36%, the accuracy of 81.25%, positive likelihood ratio of 1.42316, negative likelihood ratio is 0.25925, HOLTER examination in the diagnosis of sinoatrial node dysfunction of ROC curve area is 0.693, P value is 0.045, McNemar test based on the binomial distribution, P= 0.774 (bilateral), P>0.05, two diagnosis consistent coefficient of Kappa value was 0.029, P= 0.019, prompt the consistency inspection result is bad, comprehensive indicators said HOLTER examination has no diagnosis or rule out the ability of sinoatrial node dysfunction. The results do not support this study by HOLTER examination determination of sinoatrial node function change time to evaluate the condition of the sinoatrial node dysfunction. Through three couplet period (X) and compensatory pause between law (Y) after correlation analysis, including the analysis of the Pearson coefficient r were 0.691,0.610,0.406, is roughly moderately related, P values were= 0.000,0.000,0.001, preliminary period (X) between the union law and compensatory pause (Y) there is relationship between the two, but not both exist typical direct or inverse relationship, can only hint at different range, the relationship between the two display type. United law of interphase (X) indirect impact on compensatory intermittent (Y), and indirectly affect the length of the compensatory pause Y, further reflects the sinoatrial node function.ConelusionHOLTER with TEAP in diagnosis of sinoatrial node dysfunction has consistency, HOLTER support auxiliary diagnosis sinoatrial node dysfunction, particularly when the sinoatrial node function changes when time 0.32 s or less,HOLTER has ability to eliminate sinoatrial node dysfunction, can be used as screening such inspections. In addition, the period between the union law relation with compensatory pause, during the union between the law of influence compensatory pause,acting on the sinoatrial node function changes the change of time, thus proving HOLTER auxiliary diagnosis ability of sinoatrial node dysfunction. |
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