自主神经在阵发性心房颤动发生中的作用  

Analysis of heart rate variability of paroxysmal atrial fibrillation

作　　者：曾学寨[1] 刘德平[1] 董榕[1] 郭虹麟[1] 杨春英[1] 乔巍巍[1] 

机构地区：[1]卫生部北京医院心内科,100730

出　　处：《临床心电学杂志》2007年第3期183-186,共4页Journal of Clinical Electrocardiology

摘　　要：目的探讨自主神经在阵发性心房颤动发生中的作用。方法分析31例阵发性房颤患者47次房颤(>30s)发作前动态心电图心率变异性时域和频域指标。患者分为器质性心脏病组(19例)和非器质性心脏病组(12例)。根据房颤发作前频域指标变化,将阵发性房颤分为3组:房颤发作前心率变异性频域指标低频(LF)成分增加,LF/HF比例增加为交感神经介导房颤,房颤发作前心率变异性频域指标高频(HF)成分增加,LF/HF比例减小为迷走神经介导房颤,其余的为未分类房颤。结果器质性心脏病组房颤发作28次,其中交感神经介导房颤17次(60.7%),非器质性心脏病组房颤发作19次,迷走神经介导房颤12次(63.2%)。结论自主神经在房颤的发作中起着重要的作用,器质性心脏病中的阵发性房颤多为交感神经介导房颤,非器质性心脏病中的阵发性房颤多为迷走神经介导房颤。Objective To assess the alteration of autonomic tone by analyzing heart rate variabillty（HRV） immediately before the onset of paroxysmal atrial fibrillation （PAF）. Method Hoher tapes from 31 patients（19 patients with structural heart disease）with PAF were analyzed. A total of 47 episodes of PAF （〉30s） were recorded and submitted to time-domain and frequency-domain heart rate variability analyses; three subtypes were classifted; onset of PAF accompanied with increased HF component and decreased L/H ratio was designated as vagal type; decreased HF component and increased L/H ratio was designated as sympathetic type, and the other episodes which did not belong to vagal or sympathetic type were designated as non-related type. Result In organic group： 28 episodes of PAF were found and sympathetic type was predominant （17/28, 63.2%）; L/H ratio increased before AF onset; In idiopathic group： 19 episodes of PAF were found and vagal type was predominant （12/19, 63.2%）; HF increased significantly before the onset of AF. None of the three subtypes showed significant circadian distributions in both group. Conclusion Autonomic nervous system plays an important role in the genesis of PAF. Most of the patients with idiopathic PAF were vagal dependent and most of the patients with organic PAF were sympathetic dependent.

关 键 词：阵发性心房颤动 自主神经 心率变异性 

分 类 号：R541.75[医药卫生—心血管疾病]