阵发性心房颤动患者心房颤动发作前后、发作时体表心电图QT间期的变化  

The change of QT interval in surface electrocardiogram before,during and after episodes of paroxysmal atrial fibrillationon

作　　者：闻松男[1] 刘念[1] 白融[1] 阮燕菲[1] 李松南[1] 王悦[1] 吴晓燕[1] 康俊萍[1] 汤日波[1] 杜昕[1] 董建增[1] 刘小慧[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,北京市心肺血管疾病研究所,北京100029

出　　处：《中国心脏起搏与心电生理杂志》2014年第6期497-500,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：北京市科学技术委员会基金项目(项目编号:D131100005313007);科技部国际科技合作基金项目(项目编号:2013DFB30310);"十二五"国家科技支撑计划基金项目(中国心律失常注册研究;项目编号:2013BAI09B02)

摘　　要：目的探讨阵发性心房颤动(简称房颤)患者房颤发作前后、发作时体表心电图QT间期的变化。方法收集35例阵发性房颤患者的24 h动态心电图。测量房颤发作前窦性心律(SRbaseline)、房颤发作、房颤自行转为窦性心律即刻(SRpost AF)时的QT间期。测量连续3个心动周期QT间期。测量每阵房颤的持续时间。分别采用Bazetts、Fridericia和Framingham公式校正QT间期(QTc),分析房颤发作时间与SRpost AF的QTc之间的关系。结果SRpost AF的QTc显著短于SRbaseline的QTc[(407±38)ms vs(435±34)ms;(397±31)ms vs(423±31)ms;(393±35)ms vs(422±30)ms,P均<0.001],而房颤发作时QTc较SRbaseline、SRpost AF的QTc显著性延长[采用三种QT校正公式的QTc分别是(503±69),(454±53),(449±44)ms]。SRpost AF的QTc缩短与房颤短阵发作持续时间无显著相关,与房颤发作前的QT间期相关(相关系数分别是:0.500,0.547,0.507;P均<0.01)。结论房颤发作时QTc显著延长,而房颤发作自行转复窦性心律后QTc显著缩短。Objective To observe the change of QT interval before, during and after episodes of paroxysmal atrial fi- brillation（AF）. Methods A total of 35 patients [age （53±12） years, 48% female] with paroxysmal AF who had undergone 24 hours holter were enrolled. QT interval was measured at ： sinus rhythm before the onset of AF （ SRbaseline ） ; during AF; and sinus rhythm immediately after AF termination （SRpostAF）. For each measurement, at least 3 consecutive cardiac cycle lengths were taken. QTc was calculated in all patients using three formulas：Bazett＇s, Fridericia＇s and Framingham. Results QTc in SRpostAF was significantly shorter than that in SRbaseline[Bazett： （407±38） vs （435±34） ms; Fridericia： （397±31） vs （423±31） ms;Framingham： （393±35） vs （422±30） ms, P〈0. 001 ]. QTc in AF was significantly longer than that in SRpostAF and SRbaseling [ Bazett ： （ 503 ±69 ） ms ; Fridericia： （ 454±53 ） ms; Framingham ： （449 ±44 ） ms ]. QTc shortening in SRpostAF was not significantly correlated with the duration of episodes of paroxysmal AF but significantly correlated with QT interval before AF onset（ correlation co- efficients ： 0. 500,0. 547,0. 507 respectively ; jo values ： 0.005,0. 002,0. 004 respectively）. Conclusion QTc is significantly prolonged during AF and shorten in sinus rhythm immediately after AF termination.

关 键 词：心血管病学 心房颤动 QT间期 窦性心律 心电图 

分 类 号：R541.75[医药卫生—心血管疾病] R540.41[医药卫生—内科学]