房颤患者心电图R-R差异与射频消融术后心功能改善的关系  

Relationship between ECG R-R difference and improvement of cardiac function after ablation in patients with atrial fibrillation

作　　者：周元松 谢来柱 赵腊梅[1] 范曾 李涛[2] 吴依娜[2] 段军[2] ZHOU Yuan-song;XIE Lai-zhu;ZHAO La-mei(Cardiovascular Department,Fuyang Fifth People Hospital,Anhui 236000,China)

机构地区：[1]阜阳市第五人民医院心血管内科,安徽阜阳236000 [2]中日友好医院外科重症医学科,北京100029

出　　处：《中日友好医院学报》2022年第3期144-147,共4页Journal of China-Japan Friendship Hospital

基　　金：国家自然科学基金(81700260)。

摘　　要：目的:评价R-R差异能否预测房颤射频消融术后左心收缩功能的改善。方法:回顾研究2019年7月~2021年7月在阜阳市第五人民医院行射频消融成功的房颤患者。术后左室射血分数升高>7.5%定义为心功能改善。根据心功能变化将患者分为改善组和非改善组。对比分析2组的临床特点、心电图及超声心动图。采用多变量回归分析,筛选心功能改善的相关因素。结果:在纳入的80例患者中,改善组患者46例(57.5%)。2组在高血压及睡眠呼吸暂停综合征合并症率、心电图的R-R差异、超声心动图的左室舒张末及收缩末内径上差异均有统计学意义(P<0.05)。多变量回归分析显示,R-R差异度越高的患者,心功能改善可能性更高(OR=2.12,95%CI 1.82~2.71)。结论:高R-R差异与房颤射频消融术后左心收缩功能改善可能相关。Objective:To explore whether R-R difference can be a predictor of improvement in systolic function after atrial fibrillation ablation.Methods:The retrospective study was carried out in our hospital between July 2019 and July 2021,patients underwent atrial fibrillation ablation were all included.Left ventricular ejection fraction(LVEF)improvement was defined as absolute increase by>7.5%.According to the definition,the patients were divided into improvement group and non-improvement group.Clinical characteristics,electrocardiogram,and ultrasonic cardiogram were compared between the two groups.Multivariable logistic regression was performed to evaluate predictors of LVEF improvement.Results:A total of 80 patients were involved in this study. Forty-six(57.5%) patients were in the improvement group.The complication rate of hypertension and sleep apnea syndrome,the R-R difference of the electrocardiogram,and the left ventricular end-diastolic and end-systolic inner diameters of the ultrasonic cardiogram were significantly different between the two groups(P<0.05).Multivariable logistic regression result showed that the higher R-R difference level,the more LEVF improved(OR=2.12,95%CI 1.82-2.71).Conclusion:Higher level of R-R difference was associated with LEVF improvement after atrial fibrillation ablation.

关 键 词：R-R差异度 心房颤动 射频消融 左心收缩功能 

分 类 号：R541.7[医药卫生—心血管疾病]