P波离散度及心率变异指数与阵发性房颤射频消融术后复发的关系

发布时间：2019-03-17 08:40

【摘要】：目的探讨P波及心率变异指标与阵发性房颤消融术后复发的相关性。方法因阵发性房颤住院患者32例,进行环肺静脉线性消融术治疗,并依据术后14 d内患者是否房颤复发将患者分为房颤早期复发组(15例)和未复发组(17例),依据3个月后是否出现房颤复发将患者分为房颤晚期复发组(10例)及未复发组(22例)。对各组患者P波改变、平均心率(Mean HR)律及心率变异(HRV)等指标进行分析。结果 32例患者均达肺静脉电隔离,早期心律失常再发率为46.87%(15例),12例为房颤。心律失常发作于末期的比例为10例,9例为心房纤颤,1例为心房扑动。术前及术后最大P波时限(Pmax)与P波离散度(Pd)相比无统计学意义(P0.05);与未复发组相比,术前和术后复发组Pmax及Pd较高(P0.05)。与术前相比,术后复发组Pmax较低(P0.05),不存在复发组术后Pmax、Pd和复发组Pd较术前降低趋势。HRV指标中,与复发组相比,未复发组早期Mean HR、HRV指标较低,低频功率/高频功率(LF/HF)较高(P0.05);与复发组相比,晚期未复发组反映迷走神经的指标较低,LF/HF较高(P0.05)。结论阵发性房颤射频消融术治疗后,迷走神经可作为术后房颤再发作的检测指标。
[Abstract]:Objective to investigate the correlation between P wave and heart rate variability index and recurrence after paroxysmal atrial fibrillation ablation. Methods 32 patients with paroxysmal atrial fibrillation were treated with circumferential pulmonary vein ablation. According to the recurrence of atrial fibrillation within 14 days after operation, the patients were divided into early recurrence group (15 cases) and non-recurrence group (17 cases), and the patients were divided into two groups: the early recurrence group (15 cases) and the non-recurrence group (17 cases). The patients were divided into late recurrence group (n = 10) and non-recurrence group (n = 22) according to the recurrence of AF after 3 months. The changes of P wave, mean heart rate (Mean HR) rhythm and heart rate variability (HRV) were analyzed. Results Pulmonary venous electrical isolation was achieved in all 32 patients. The recurrence rate of early arrhythmias was 46.87% (15 cases) and atrial fibrillation was found in 12 cases. The incidence of arrhythmias at the end stage was 10 cases, 9 cases were atrial fibrillation and 1 case was atrial flutter. There was no significant difference between pre-and post-operation maximum P-wave duration (Pmax) and P-wave dispersion (Pd) (P0.05), but Pmax and Pd were higher in pre-and post-recurrence group than those in non-recurrence group (P0.05). Compared with pre-operation, Pmax in recurrence group was lower than that before operation (P0.05), and there was no tendency to decrease postoperative Pmax,Pd in recurrence group and Pd in recurrence group. Compared with recurrence group, early Mean HR,HRV index in non-recurrence group was lower than that in non-recurrence group, and there was no significant difference between recurrence group and recurrence group (P < 0.05). Low-frequency power / high-frequency power (LF/HF) was higher (P0.05); Compared with recurrent group, the index of vagus nerve in late stage non-recurrence group was lower and LF/HF was higher (P0.05). Conclusion after radiofrequency ablation of paroxysmal atrial fibrillation, vagus nerve can be used as an index of postoperative recurrence of atrial fibrillation.
【作者单位】：中山大学附属第五医院心内科心电生理&监护病区心电图室;中山大学附属第五医院康复科;中山大学附属第五医院心内科;
【分类号】：R541.75

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