碎裂QRS波对肥厚型心肌病伴心房颤动患者导管消融术后复发的预测价值  

Predictive value of fragmented QRS wave for recurrence after catheter ablation in patients with hypertrophic cardiomyopathy and atrial fibrillation

作　　者：李邦合 万海伟 董鹏[1] 李伟[1] 颜平 LI Banghe;WAN Haiwei;DONG Peng;LI Wei;YAN Ping(The Second Department of Cardiology,Aviation General Hospital,Beijing 100012,China;Department of Cardiovascular Internal Medicine,the Third Medical Center of PLA General Hospital,Beijing 100012,China)

机构地区：[1]航空总医院心内二科,北京100012 [2]解放军总医院第三医学中心心血管内科,北京100012

出　　处：《中国医药导报》2019年第21期181-184,共4页China Medical Herald

基　　金：首都卫生发展科研专项项目(2016-3-2023)

摘　　要：目的探讨碎裂QRS波对肥厚型心肌病伴心房颤动(以下简称“房颤”)患者导管消融术后的复发的预测价值。方法选取2016年2月~2018年2月于航空总医院接受导管消融术治疗的肥厚型心肌病伴房颤患者95例作为研究对象。按照术后是否复发将所有患者分为复发组(45例)与未复发组(50例)。分别比较两组患者一般资料、心功能相关指标水平、手术时间、透视时间、碎裂QRS波以及校正QT间期(QTc)情况,并进行多因素Logisitic回归分析。结果两组年龄、性别、阵发性房颤患者占比以及房颤病程比较,差异均无统计学意义(均P>0.05)。复发组左心房内径大于未复发组,差异有统计学意义(P<0.01)。复发组碎裂QRS波患者占比、QTc水平均高于未复发组,差异均有高度统计学意义(均P<0.01)。多因素Logisitic回归分析发现,碎裂QRS波、QTc均是肥厚型心肌病伴房颤患者导管消融术后复发的危险因素(均P<0.01)。结论碎裂QRS波与QTc对肥厚型心肌病伴房颤患者导管消融术后的复发的预测价值较高,值得临床应用。Objective To investigate the predictive value of fragmented QRS wave for recurrence in patients with hypertrophic cardiomyopathy and atrial fibrillation after catheter ablation.Methods A total of 95 patients with hypertrophic cardiomyopathy and atrial fibrillation who underwent catheter ablation at the Aviation General Hospital from February 2016 to February 2018 were enrolled.All patients were divided into recurrent group(45 cases)and non-recurrence group(50 cases)according to whether there was recurrence after operation.The general data,levels of cardiac function related index,operation time,fluoroscopy time,fragmentation QRS wave and corrected QT interval(QTc)were compared between the two groups,and multivariate Logisitic regression analysis was performed.Results There were no significant differences in the age,gender,paroxysmal atrial fibrillation and atrial fibrillation between the two groups(all P>0.05).The left atrial diameter of the recurrent group was greater than that of the non-recurrent group,and the difference was highly statistically significant(P<0.05).The proportion of patients with fragmentation QRS wave and the QTc level in the recurrent group were higher than those in the non-recurrent group,the differences were highly statistically significant(all P<0.01).Multivariate Logisitic regression analysis found that both fragmentation QRS wave and QTc were risk factors for recurrence after catheter ablation in patients with hypertrophic cardiomyopathy and atrial fibrillation(all P<0.01).Conclusion Fragmentation of QRS and QTc have high predictive value for recurrence after catheter ablation in patients with hypertrophic cardiomyopathy and atrial fibrillation.It is worthy of clinical application.

关 键 词：肥厚型心肌病 心房颤动 导管消融术 碎裂QRS波 复发 

分 类 号：R541.75[医药卫生—心血管疾病] R542.2[医药卫生—内科学]