心房颤动伴长RR间期患者射频消融术后的心律变化  

Heart rhythm changes after radiofrequency ablation in patients with atrial fibrillation complicated with prolonged RR interval

作　　者：刘丹 张元婷 吕庆坤 顾佳宁 徐迎佳 王张生 LIU Dan;ZHANG Yuanting;LYU Qingkun;GU Jianing;XU Yingjia;WANG Zhangsheng(Department of Cardiology,Shanghai Fifth People′s Hospital,Fudan University,Shanghai 200240;Ma Qiao Community Health Service Center,Shanghai 201111;Jiang Chuan Community Health Service Center,Shanghai 200240,China)

机构地区：[1]上海复旦大学附属上海市第五人民医院心内科,200240 [2]江川社区卫生服务中心,上海200240 [3]马桥社区卫生服务中心,上海201111

出　　处：《国际心血管病杂志》2021年第6期376-379,共4页International Journal of Cardiovascular Disease

基　　金：上海市闵行区卫生健康委员会(2018MW05);上海市科学技术委员会(19411971900);闵行区医学特色专科建设(2020MWTZB01)。

摘　　要：目的:观察心房颤动(房颤)伴长RR间期患者在经导管射频消融治疗后的心律变化。方法:纳入行射频消融治疗的房颤患者336例,其中阵发性房颤203例,持续性房颤133例。依据手术前后24 h动态心电图结果,比较两组患者最长RR间期值及长RR间期次数。采用单因素及多因素线性回归探索最长RR间期改善的相关因素。结果:平均随访23.5个月,随访期间各组均无起搏器植入。与术前相比,术后阵发性及持续性房颤患者RR>3 s的间期次数均无统计学差异。对于阵发性房颤患者,多因素线性回归分析提示年龄与最长RR间期减少幅度呈负相关趋势(95%CI:-22.37~1.48,P=0.086),血钾与最长RR间期减少幅度呈正相关(95%CI:89.69~523.49,P=0.006);对于持续性房颤患者,多因素线性回归分析提示左房体积与最长RR间期减少幅度呈负相关(95%CI:-15.34~-4.15,P=0.001)。结论:房颤发作时窦房结功能受抑制,从而出现长RR间期;在射频消融消除房颤后,长RR间期有一定程度的改善。Objective:To evaluate rhythm changes following catheter radiofrequency ablation in patients with atrial fibrillation(AF)complicated with long RR interval.Methods:A total of 336 AF patients treated with catheter radiofrequency ablation were included,including 203 patients with paroxysmal AF and 133 patients with persistent AF.The times and maximum length of long RR interval in Holter before and after ablation were compared in the two cohorts,respectively.Univariate and multivariate linear regress analysis were applied to explore the relevant factors of the maximum RR interval improvement.Results:The mean follow-up period was 23.5 months,during which no pacemaker was implanted.For times of RR interval>3 s,there were no significant differences before and after ablation in patients with paroxysmal AF(P=0.221),neither did patients with persistent AF(P=0.281).For patients with paroxysmal AF,multivariate linear regression analysis suggested that age had a trend to be negatively correlated with the maximum RR interval reduction(95%CI-22.37 to 1.48,P=0.086),and serum potassium level was positively correlated with the maximum RR interval reduction(95%CI 89.69 to 523.49,P=0.006).For patients with persistent AF,multivariate linear regression analysis suggested a negative correlation between left atrial volume and the maximum RR interval reduction(95%CI-15.34 to-4.15,P=0.001).Conclusions:The function of sinoatrial node is inhibited during AF,leading to a long RR interval.After radiofrequency ablation,the long RR interval could be improved to a certain extent.

关 键 词：心房颤动 快-慢综合征 长RR间期 射频消融 

分 类 号：R541.75[医药卫生—心血管疾病]