心房顫動的篩查與診斷

年滿65歲或以上及/或有心房顫動(又稱「房顫」)風險因素的人士通常會在例行身體檢查時接受房顫篩查。1

通常,房顫篩查的第一步是檢查脈搏(脈搏觸診)。醫生可能會在診症時為病人觸診,或者請病人在家中自行測量脈搏。但如要診斷房顫,就需要進行如心電圖測試等詳細的醫療檢查。1-4

觀看短片﹐了解如何檢查自己的心率和心律

要知道自己是否患上房顫,檢查脈搏或許是個不錯的方法

脈搏(通常稱為「心率」)是指心臟每分鐘跳動的次數。5 檢查脈搏有助醫生和病人知道心率狀況。

正常狀態下的心率(即你的靜止心率)應該像時鐘一樣有規律地跳動,為每分鐘60至100次。6 房顫患者的心率往往可能遠高於每分鐘100次,而且每次心跳節奏紊亂。4

由於心率會在日常和不同體能活動而變動。因此,如果要量度靜止心率,應該在早上睡醒後第一時間在床上檢查脈搏。5,6

test

請按照以下步驟自行檢查脈搏﹕4,6

  • 靜坐五分鐘,除下所有手錶和首飾,然後放鬆。測量脈搏前請勿吸煙或攝取咖啡因,因為 它們會使心率加快
  • 將手放下,手掌朝上,手肘微曲
  • 用另一隻手的食指及中指按壓在手腕處(大姆指根部附近)
  • 保持力度,按住手腕,並計算30秒內的心跳次數
  • 將數字乘二,得出每分鐘的心跳次數

如果感覺脈搏震顫、加快或不規則,便要持續測量一分鐘,而且不要將心跳次數乘6

手腕是最容易測量脈搏的部位,但亦可以在手肘內側、鼠蹊部或膝蓋後方摸到脈搏。6

如果在測量脈搏時發現異常情況,或者需要別人指導,請約見醫4,6

如感到胸口痛,請立即求醫。4

1.Heart Foundation. Clinical fact sheet: atrial fibrillation screening and diagnosis work up. February 2019. Available at https://www.heartfoundation.org.au/getmedia/44a3ff91-01a7-4ee6-bb2c-cd50ddd79cb2/Clinical_Fact_Sheet_-_AF.pdf. Last accessed November 2020.

2. NICE NG196. Atrial fibrillation: diagnosis and management. 2021. Available at https://www.nice.org.uk/guidance/ng196/resources/atrial-fibrillation-diagnosis-and-management-pdf-66142085507269. Last accessed May 2021.

3. Taggar JS et al. Eur J Prev Cardiol 2016; 23: 1330-1338.

4. NHS. Diagnosis – atrial fibrillation. April 2018. Available at https://www.nhs.uk/conditions/atrial-fibrillation/diagnosis/. Last accessed November 2020.

5. PeaceHealth. Pulse Measurement – Test overview. March 2019. Available at https://www.peacehealth.org/medical-topics/id/hw233473. Last accessed November 2020.

6. Arrhythmia Alliance. Know Your Pulse Factsheet. April 2009; reviewed January 2017. Available at https://www.heartrhythmalliance.org/resources/view/389/pdf. Last accessed November 2020.

7. NHS. Electrocardiogram (ECG). June 2018. Available at https://www.nhs.uk/conditions/electrocardiogram/. Last accessed November 2020.

8 PMS Instruments. Why You Should Use ECG Event Recorders in Primary Care. October 2014. Available at https://www.pmsinstruments.co.uk/blog/why-you-should-use-ecg-event-recorders-in-primary-care/. Last accessed November 2020.

9. WebMD. How Atrial Fibrillation Is Diagnosed. May 2018. Available at https://www.webmd.com/heart-disease/atrial-fibrillation/afib-diagnosis#1. Last accessed November 2020.

10. British Heart Foundation. ECG. Available at https://www.bhf.org.uk/informationsupport/tests/ecg. Last accessed November 2020.

11. Galli A, et al. Arrhythm Electrophysiol 2016; 5: 136-143.

12. ECG event recorder (R test). Royal Brompton & Harefield NHS Foundation Trust. Available at https://www.rbht.nhs.uk/our-services/ecg-event-recorder-r-test. Last accessed November 2020.

PP-ELI-HKG-0642 JUN 2021