起搏器安置术后心房颤动发生情况的远期随访  

Atrial fibrillation after pacemaker implantation:long-term follow-up in single center

作　　者：吴冬燕[1] 郝晓东[2] 张洁[1] 王林[1] 马薇[1] 卢凤民[3] 许静[1] 

机构地区：[1]天津市胸科医院心内科,天津300222 [2]天津市第一中心医院 [3]天津市胸科医院心内,科天津300222

出　　处：《中国心脏起搏与心电生理杂志》2016年第1期22-25,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：天津市卫生局重点攻关项目(编号:11KG124)

摘　　要：目的研究首次接受起搏治疗的患者心房颤动(简称房颤)发生情况及预后影响因素。方法回顾性分析本院2003年至2008年初次安置永久起搏装置窦性心律患者的临床和随访资料,统计术后房颤的发生情况,单因素分析筛选出房颤发生的危险因素,以Cox风险比例模型筛选房颤发生的独立预后因素。结果共入选1 344例,经过(75.7±24.5)个月的随访患者房颤发生率21.1%,其中持续房颤发生率10.8%。经Cox风险模型筛选出与房颤发作关系最为密切的5个因素:既往有阵发房颤病史、病因为病窦综合征、肺动脉压力高于正常、年龄≥65岁、VVI起搏模式,其风险比分别为3.43、1.86、1.65、1.4、1.3,经Kaplan-Meier方法分析,前述因素在随访中位数77个月时分别增加房颤风险31%、15.9%、6.1%、4.8%、5.5%。结论房颤在老年、VVI起搏、病窦综合征、阵发房颤病史、肺动脉压力增高的患者中发生比例高。Objective To evaluate the risk factors of atrial fibrillation（AF） in patients with right ventricular apex pacing. Methods The clinical data of AF patients who received pacemaker implantation at our hospital from 2003 to 2008 were analyzed retrospectively. All the patients had sinus rhythm and their ventricular electrodes were placed in right ventrieular apex. Cox proportional hazard model was used to identify the predictors of AF episode during cardiac pacing. Results Analysed data from 1 344 patients. After （75.7±24.5） months follow-up, 285（21.1%） patients experienced AF, 145 patients（10.8%） developed persistent AF. Multivariate Cox analysis revealed 5 prognostic factors for AF after pacing： paroxysmal AF history（hazard ratio, 3.43）, sick sinus syndrome etiology（hazard ratio, 1.86）, pulmonary hypertension（hazard ratio, 1.65）, age≥65 years（hazard ratio, 1.4） and VVI pacing mode （hazard ratio, 1.3）. Conclusions Development of AF is common in apex pacing population , particularly among patients with paroxysmal AF history, sick sinus syndrome indication, pulmonary hypertension, age≥65 years and VVI pacing mode.

关 键 词：心血管病学 右室心尖部 起搏 心房颤动 发生率 预后因素 

分 类 号：R541.75[医药卫生—心血管疾病] R318.11[医药卫生—内科学]