老年对慢性心房颤动患者左房复杂碎裂电位的影响  

Aging and complex fractionated atrial electrograms in patients with chronic atrial fibrillation

作　　者：汤日波[1] 董建增[1] 尚美生[1] 杜昕[1] 龙德勇[1] 喻荣辉[1] 康俊萍[1] 吴嘉慧[1] 白融[1] 宁曼[1] 桑才华[1] 蒋晨曦[1] 李松南[1] 马长生[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科,房颤中心,北京100029

出　　处：《中国心脏起搏与心电生理杂志》2014年第5期420-422,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：北京市科技新星(2009B32);国家自然科学基金资助项目(30900628;81241005);北京市优秀人才(2010D003034000025);北京市自然科学基金资助项目(No.7102048);北京市卫生系统高层次卫生技术人才培养计划(2013-3-007);北京市十百千卫生人才(百层次)培养计划

摘　　要：目的评价老年对非瓣膜病心房颤动(简称房颤)患者左房复杂碎裂电位(CFAEs)的影响。方法前瞻性入选116例行导管消融的慢性房颤患者。以60岁为界,分为老年组(n=48)与非老年组(n=68)。在CARTO系统指导下记录局部稳定的心内膜电图。应用CARTO系统内置的CFAEs分析软件进行分析。以间期置信水平(ICL)来评估CFAEs的特点。CFAEs指数定义为ICL≥7区域的面积与左房表面积的比值。将左房分为前壁、后壁、顶部、下壁、外侧壁、间隔六个部分,评价CFAEs在左房不同位置的分布特征。结果老年组男性患者比例显著低于非老年组,合并高血压、脑卒中的比例显著高于非老年组(P均<0.05)。老年组最大ICL显著大于非老年组[(16.7±2.0)vs(15.7±2.2),P=0.014)],老年组CFAEs指数显著高于非老年组[(60.4%±22.9%)vs(48.6%±22.3%),P=0.007)]。老年组左房前壁、间隔的CFAEs的分布比例显著大于非老年组。年龄与CFAEs指数呈正相关(r=0.244,P=0.008)。结论老年慢性房颤具有广泛的CFAEs。Objective To investigate the impact of aging on complex fractionated atiral electrograms （CFAEs） in patients with non-valvular chronic atrial fibrillation （AF）. Methods In this prospective study, 116 patients with chronic AF were enrolled （n=48 in the elderly group, n=68 in the non elderly group）. The elderly was defined as age ≥ 60 years old. The 2.5-second bipolar electrogram recordings at each endocardial location were analyzed with a custom software embedded in the CARTO mapping system. Interval confidence level （ICL） was used to characterize CFAEs. As the default setting of the software, ICL more than or equal to 7 was considered sites with a highly repetitive CFAEs complex. CFAEs index was defined as the fraction of area of ICL more than or equal to 7 to the left atrial surface. The spatial distribution of CFAEs evaluated in six left atrial（LA） regions： anterior wall, posterior wall, roof, inferior wall, lateral wall and septum. Results The elderly group had higher prevalence of male, hypertension and stroke（ all P〈0.05 ）. ICL max [ （ 16.7±2. 0） vs （ 15.7 ±2.2） ,P = 0.014 ] and C FAEs index [ （60.4% ±22.9% ） vs （48.6% ±22.3% ）, P = 0. 007 ] in the elderly group was significantly higher than that in the non-elderly group. The regional distribution of CFAEs, was frequently found in Condusion LA anterior wall and LA septum in the elderly. Age had positive relation with CFAEs （r = 0. 244, P = 0. 008 ）. The elderly have extensive substrate for chronic AF.

关 键 词：心血管病学 老年 心房颤动 复杂碎裂电位 基质 

分 类 号：R541.75[医药卫生—心血管疾病]