心率减速力联合体表心电图V1导联f波振幅对心房颤动射频消融术后复发的预测价值  

Predictive value of deceleration capacity of heart rate combined with fibrillatory wave amplitude on lead V_1 of surface electrocardiography in atrial fibrillation patients with recurrence after radiofrequency catheter ablation

作　　者：宋玮[1] 闫文菊[1] 张焕轶[1] 郭忠秀[1] 周发展[1] Song Wei;Yan Wenju;Zhang Huanyi;Guo Zhongxiu;Zhou Fazhan(Department of Cardiology, Taian City Center Hospital, Taian 271000, China)

机构地区：[1]泰安市中心医院心内科,山东泰安

出　　处：《中华介入放射学电子杂志》2016年第4期202-206,共5页Chinese Journal of Interventional Radiology：electronic edition

基　　金：山东省自然科学基金项目(ZR2015HL005)

摘　　要：目的:探讨心率减速力(DC)联合体表心电图V_1导联f波平均振幅对心房颤动(AF)患者射频消融术后复发的预测价值。方法:选取2015年6月—2016年6月因AF在我院住院并行首次射频消融术的患者56例,根据术后随访结果分为未复发组36例,复发组20例。统计两组患者一般资料、DC值及体表心电图V_1导联f波平均振幅并进行比较,建立Logistic回归模型,筛选AF患者射频消融术后复发的危险因素,分别对DC值、体表心电图V_1导联f波平均振幅及二者联合进行受试者工作特征(ROC曲线)绘制,评价二者联合对AF术后复发的预测价值。结果:复发组患者DC值(5.89±1.00)ms高于未复发组(4.88±0.99)ms、体表心电图V_1导联f波平均振幅(0.094±0.014)m V小于未复发组(0.109±0.018)m V,差异均有统计学意义;术后DC较术前明显下降;经多因素Logistic回归分析显示,DC值大、体表心电图V_1导联f波平均振幅小是AF患者射频消融术后复发的独立危险因素;DC值、体表心电图V_1导联f波平均振幅预测AF术后复发的ROC曲线下面积分别为0.764、0.748,二者比较无统计学差异(P=0.86),二者联合预测AF术后复发曲线下面积为0.837,高于各自值(P<0.05)。结论 DC联合体表心电图V_1导联f波平均振幅对心房颤动射频消融术后复发具有预测价值。Objective: To explore the predictive value of deceleration capacity of heart rate(DC) combined with fibrillatory wave amplitude on lead V1 of surface electrocardiography in atrial fibrillation(AF) patients with recurrence after radiofrequency catheter ablation. Methods: 56 AF patients who underwent radio frequency catheter ablation for the first time from June 2015 to June 2016 were selected for this study. According to the followup results, these patients were divided into the non-recurrent group (n=36) and the recurrent group (n=20). Their basic information, DC values, fibrillatory wave amplitude on lead V1 of surface electrocardiography were collected and compared to establish a Logistic regression model, based on which, the risk factors for AF patients after radiofrequency catheter ablation were screened. DC values, fibrillatory wave amplitude on lead V1 of surface electrocardiography and the combination of the two methods were depicted into Receiver operating curve (ROC), and to evaluate the predictive value of the combination of the two methods on the recurrence of the AF patients who underwent radio frequency catheter ablation. Results: The DC value in the recurrence group (5.89±1.00) was higher than that in the non recurrence group(4.88±0.99). The fibrillatory wave amplitude on lead V1 of surface electrocardiography in the recurrence group (0.094±0.014 mV) was less than that in the non recurrence group(0.109±0.018 mV) (all P<0.05). Postoperative DC was significantly decreased compared with the preoperative value. Multivariate Logistic regression analysis showed that the DC value、fibrillatory wave amplitude on lead V1 of surface electrocardiography are independent risk factors for recurrence after radiofrequency ablation in AF patients. The ROC curves of DC and mean amplitude showed AUC were 0.764 and 0.748(P=0.86). The ROC curves of combination of the two methods showed AUC was 0.837, higher than their respective values (P < 0.05). Conclusions: Deceleration capacity of heart rate(DC) combined with f

关 键 词：心率减速力 F波振幅 心房颤动 射频消融 复发 

分 类 号：R541.75[医药卫生—心血管疾病]