持续性心房颤动患者左心耳电位分类及影响因素研究  

Classification of left atrial appendage potential and influence factors in patients with persistent atrial fibrillation

作　　者：赵乾磊 王彬浩 储慧民[2] ZHAO Qianlei;WANG Binhao;CHU Huimin(Department of Cardiology,Yinzhou People's Hospital,Ningbo 315040,China)

机构地区：[1]宁波市鄞州人民医院心内科,315040 [2]宁波市第一医院心内科

出　　处：《心电与循环》2020年第4期369-373,378,共6页Journal of Electrocardiology and Circulation

摘　　要：目的探讨影响持续性心房颤动(下称房颤)患者左心耳电位的因素。方法选择2015年1月至2017年1月期间行导管消融的持续性房颤患者152例,根据术中记录到的左心耳电位分为规则组、碎裂组、混合组,记录并比较各组之间的病史、心功能、左心房和左心耳大小。结果碎裂组患者发病时限中位数高于规则组,差异有统计学意义(P<0.01)。碎裂组的心功能大于Ⅱ级的比例、左心耳口部直径、CHA2DS2-VASc评分均高于规则组、混合组,差异有统计学意义(均P<0.01)。碎裂组、混合组左心房直径均高于规则组,差异均有统计学意义(均P<0.01)。左心房大小是混合组左心耳电位的独立影响因素(OR=1.124,95%CI:1.035~1.221,P<0.01),发病时限(OR=1.011,95%CI:1.001~1.022,P<0.05)、左心耳口部直径(OR=1.192,95%CI:1.039~1.368,P<0.01)和心功能大于Ⅱ级(OR=13.178,95%CI:1.553~111.840)是碎裂组左心耳电位的独立影响因素。结论持续性房颤患者发病时限、心功能分级、CHA2DS2-VASc评分、左心房直径及左心耳口部直径与左心耳电位形态相关。Objective To assess the factors influencing left atrial appendage(LAA)potential in patients with persistent atrial fibrillation(AF).Methods A total of 152 patients underwent catheter ablation of persistent AF were enrolled from January 2015 to January 2017.They were divided into regular group,fractionated group and mixed group based on LAA potential recorded during procedure.Disease history,heart function,the diameter of left atrium(LA)and LAA were recorded and compared among 3 groups.Results AF duration was significantly greater in fractionated group than regular group(P<0.01).The percentage of NYHA class>Ⅱ,CHA2DS2-VASc score and LAA ostial diameter were significantly greater in fractionated group than in regular and mixed groups(all P<0.01).LA diameter in fractionated and mixed groups was significantly greater than in regular group(all P<0.01).LA diameter was an independent factor influencing LAA potential in mixed group(OR=1.124,95%CI:1.035~1.221,P<0.01).AF duration(OR=1.011,95%CI:1.001~1.022,P<0.05),LAA ostial diameter(OR=1.192,95%CI:1.039~1.368,P<0.01)and NYHA class>Ⅱwere independent factors influencing LAA potential in fractionated group.Conclusion NYHA class,CHA2DS2-VASc score,LA size,LAA ostial diameter,and AF duration are associated with pattern of LAA electrograms.

关 键 词：心房颤动 左心耳电位 碎裂电位 影响因素 

分 类 号：R541.75[医药卫生—心血管疾病]