环肺静脉前庭电隔离对阵发性心房颤动患者消融术后心率的影响  

The effect of left atrium circumferential pulmonary vein ablation on heart rate of patients with paroxysmal atrial fibrillation

作　　者：陶四明[1] 郑甲林[1] 李建美[1] 魏巍[1] 杨志刚[1] 

机构地区：[1]云南省第二人民医院心脏内科,昆明市650021

出　　处：《中国心血管病研究》2012年第2期127-130,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 对比观察阵发性房颤射频消融术前后窦性心率变化，探讨环肺静脉前庭电隔离对迷走神经作用的影响。方法入选阵发性房颤患者93例，入院完善相关检查，行环肺静脉前庭电隔离消融术。术前，术后1周、3个月、12个月做动态心电图检测患者心率的相关指标并统计对比分析。结果①术前，术后1周、3个月、12个月MaxHR、MinHR、MeanHR比较，分别为F=I．874、P=0．137，F=4．909、P=0．003，F=5．136、P=0．003，其中MinHR与MeanHR差异有统计学意义；组间两两比较，术前与术后1周后两者差异有统计学意义。②术前，术后1周、3个月、12个月时域指标SDNN、RMSSD、pNN50比较，分别为F=7．384、P=0．000，F=5．607、P=-0．002，F=10．23、P=0．000，差异有统计学意义；组间两两比较，术前与术后1周三者差异均有统计学意义。③术前，术后1周、3个月、12个月频域指标LF、HL、LF／HF比较，分别为F=3．377、P=0．027，F=2．941、P=0．040，F=2．414、P=0．061，其中LF、HL差异有统计学意义；组间两两比较，术前与术后1周前两者差异有统计学意义。结论阵发性房颤射频消融术后，部分患者会出现短期内心率增快，心率变异性降低，3个月后逐渐恢复到术前水平。提示肺静脉前庭电隔离在一定程度上达到左房去除迷走神经作用，损伤了房颤的发病基质。Objective To investigate the effect of vagal denervation on heart rate of patients with paroxysmal atrial fibrillation by catheter ablation. Methods Selected 93 patients with paroxysmal atrial fibrillation undergone circumferential pulmonary vein isolation ablation. Dynamic electrocardiogram with heart rate related parameters were evaluated preoperative, postoperative 1 week, 3 months and 12 months, and the data were statistical analyzed. Results （1）Compared MaxHR, MinHR, MeanHR preoperative, postoperative 1 week, 3 months, 12 months, F=1.874, P=-0.137, F=4.909, P=0.003, F=5.136, P=-0.003. The MinHR and MeanHR were statistically difference （P〈0.05） preoperative and postoperative 1 week. （2）Compared time domain SDNN, RMSSD, pNNS0 preoperative, postoperative 1 week, 3 months and 12 months, the statistics values were F=7.384, P= 0.000, F=5.607, P=-0.002, F= 10.23, P=0.000. When compared between groups preoperative and postoperative 1 week, there was statistically difference （P〈0.05）. （3）Preoperative, postoperative 1 week, 3 months, 12 months frequency domain LF, HL, LF/HF comparison, F=3.377, P=0.027, F=2.941, P=0.040, F=2.414, P=0.061, LF and HL, P〈0.05. Comparison between groups preoperative and postoperative 1 week, the value was statistical- ly significant. Conclusion Radiofrequency ablation of paroxysmal atrial fibrillation, some patients＇ heart rate may be accelerate short-term, reduce heart rate variability, then gradually return to preoperative level after three months.

关 键 词：心房颤动 心率变异性 去迷走神经 射频消融 环肺静脉消融 

分 类 号：R541.75[医药卫生—心血管疾病]