阵发性心房颤动发作特点的研究  

Characteristics of the onset of paroxysmal atrial fibrillation

作　　者：吴瑛[1] 牛国栋[2] 李宏才[2] 李彦东[2] 支力大[2] 尹彦琳[2] 

机构地区：[1]北京大学护理学院,100083 [2]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院

出　　处：《中华心律失常学杂志》2001年第3期142-144,共3页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的 分析阵发性心房颤动（房颤）的发作特点。方法　４２例阵发性房颤患者分成有器质性心脏病和无可发现的器质性心脏病 ２组，共进行 ４５次 ２４ ｈ动态心电图检查，对比房颤发作前 ３０ｍｉｎ和 １ｍｉｎ的窦性心室率，以及诱发和不诱发房颤的房性早搏的配对间期（ＰＰ＇）和早搏指数（ＰＩ）。结果随机抽取５３例次的阵发性房颤样本。房颤发作前３０ ｍｉｎ和 １ｍｉｎ的平均窦性心室率改变不显著，但 １４例次（３３％）和１５例次（３６％）房颤发作前分别出现窦性心室率显著减慢和显著加快，１５例次（３６％）房颤发作前１ｍｉｎ的窦性心室率＜６０次／ｍｉｎ。与５３个不诱发房颤的房性早搏相比，４８个诱发房颤的房性早搏的ＰＰ＇间期和ＰＩ均显著缩短（Ｐ＜０．００１）。有器质性心脏病和无器质性心脏病的２组阵发性房颤患者的各项观察指标差异均元显著性。结论 短配对间期的房性早搏是阵发性房颤的独立诱发因素。部分患者的房颤发作与心动过缓有关，采取相应的治疗措施可能预防房颤的发生。Objective To investigate the characteristics of the onset of paroxysmal atrial fibrillation (PAF). Methods Forty two consecutive patients with paroxysmal atrial fibrillation were enrolled and divided into two groups: one group with underlying organic heart disease and another group without. Retrospectively analyzed the onset pattern of each episodes of PAF selected from 45 24-hour Holter monitoring and compared the ventricular rate of sinus rhythm at 30 minutes and 1 minute immediately before the onset of PAF, the coupling interval (PP') and prematurity index (PI)of premature atrial contractions (PACs) eliciting PAF and isolated PACs. Results Total 53 episodes of PAF were randomly chosen as the study samples. There was no significant changes between the ventricular rate of sinus rhythm at 30 minutes and 1 minute immediately before the onset of PAF, however, significant reducing and increase- ing in ventricular rate of sinus rhythm at 30 minutes and 1 minute immediately before the onset of PAF were observed in 14 (33% )episodes and 15 (36% )episodes of PAF respectively. Meanwhile sinus bradycardia was observed in 15 (36%) episodes before the onset of PAF. The PP' and PI of 48 PACs eliciting PAF were significantly shorter than those of 53 isolated PACs (P <0.001). There were no significant differences in all above parameters between these two groups. Conclusion PACs with shorter PP' is an independent factor eliciting PAF. In some patients, the onset of PAF is correlated to sinus bradycardia. Therapies such as atrial pacing for stabilizing heart rate may effectively pre- vent the onset of PAF.

关 键 词：心房颤动 房性早搏 心率 配对间期 

分 类 号：R541.7[医药卫生—心血管疾病]