安置心脏起搏器患者术后心房颤动的多因素分析  

Multivariate analysis of persistent atrial fibrillation after permanent pacing

作　　者：张淑立[1] 任自文[1] 丁燕生[1] 周菁[1] 杨俊娟[1] 苏加林[1] 张丽芳[1] 

机构地区：[1]北京大学第一医院心内科,100034

出　　处：《中华心血管病杂志》2001年第9期546-548,共3页Chinese Journal of Cardiology

摘　　要：目的　观察安置心脏起搏器患者术后发生心房颤动 (房颤 )的相关因素。方法　回顾性随访了 10 7例安装起搏器的患者 ,其中VVI(R)组起搏器共 5 3例 ,随访时间为 ( 7 0 9± 4 13 )年 ;房室顺序起搏组AAI、VDD(R)、DDD(R)型起搏器共 5 4例 ,随访时间为 ( 3 41± 2 2 1)年。随访时收集患者置入起搏器时的年龄、心律失常的类型、术前有无阵发性房颤、起搏器的类型、至随访时起搏器置入时间以及术后发生持续性房颤的时间 ,每例患者至少有一份心电图 ,部分患者做Holter检查 ,明确是否发生持续性房颤。通过统计学Logistic回归分析 ,阐明不同类型起搏器术后发生房颤的影响因素。结果　随访的 10 7例中共有 17例发生持续性房颤 ;其中VVI(R)组 12例 ,房颤的发生率为 2 2 64%;房室顺序起搏组 5例 ,房颤的发生率为 9 2 6%。在VVI(R)组 ,病态窦房结综合征、原有阵发性房颤、起搏器置入后时间均为术后发生房颤的独立影响因素 ;在房室顺序起搏组 ,只有原有阵发性房颤是术后发生房颤的影响因素。结论　起搏器术后发生房颤有多种影响因素 ,其中在VVI(R)组 ,病态窦房结综合征、原有阵发性房颤及起搏器置入后时间均为术后发生持续性房颤的独立影响因素 ;在房室顺序起搏组 ,原有阵发性房颤为术后发生持续性房颤的影响因素?Objective To investigate the related factors leading to persistent atrial fibrillation after permanent pacing. Methods 107 patients were analyzed retrospectively.53 patients receiving VVI(R) pacemakers were followed up for (7.09±4.13) years, and 54 patients with A-V sequential pacemakers[AAI,VDD(R),DDD(R)]were followed up for (3.41±2.21)years. The data on patients′ age when pacemakers implanted, type of arrhythmias (sick sinus syndrome or atrioventricular block),paroxysmal atrial fibrillation before implantation, type of pacemakers, the duration from implantation to the time when persistent atrial fibrillation occurred were collected. Logistic regression analysis was used to analyze above factors affecting persistent atrial fibrillation after permanent pacing. Results Persistent atrial fibrillation rate was 22.64% (12/53) in VVI(R)pacing group, SSS, paroxysmal atrial fibrillation before implantation and duration after implantation were all affecting factors(P=0.09, 0.13, 0.05 respectively); persistent atrial fibrillation rate was 9.26%(5/54) in A-V sequential pacing group, and paroxysmal atrial fibrillation before implantation was the only affecting factor(P=0.03).Conclusions The development of persistent atrial fibrillation was affected by many factors. Compared with VVI(R) pacing,A-V sequential pacing had fewer affecting factors. To avoid the development of persistent atrial fibrillation, A-V sequential pacing should be selected.

关 键 词：人工心脏起搏 心房颤动 多因素分析 

分 类 号：R541.7[医药卫生—心血管疾病]