不同房颤持续时间患者之间窦房结及房室结功能的差异研究  

Study on the differences of sinus node and atrioventricular node function among patients with different durations of atrial fibrillation

作　　者：刘婷[1] 陈万国[1] LIU Ting;CHEN Wanguo(Electrocardiogram Room,Meizhou People’s Hospital,Guangdong,Meizhou 514031,China)

机构地区：[1]广东省梅州市人民医院心电图室,广东梅州514031

出　　处：《中国医药科学》2022年第15期178-181,共4页China Medicine And Pharmacy

基　　金：广东省梅州市医药卫生科研课题(2019-B-40)。

摘　　要：目的 探讨不同房颤持续时间患者之间窦房结及房室结功能的差异。方法 选择2019年2月至2021年5月梅州市人民医院动态心电图房颤合并长RR间期(≥1.5 s)患者50例作为对象,根据房颤持续时间是否>48 h分为两组。≤48 h组患者行体外同步直流电复律或药物复律,>48 h组患者先进行3周抗凝后再进行复律,转为窦性心律后停用洋地黄药物及抗心律失常药物,两组均完成食管心脏电生理检测,比较两组窦房结功能、房室结前传不应期及文氏点、2∶1阻滞点。结果 ≤48 h组成功率为84.00%,高于>48 h组的64.00%(P <0.05);≤48 h组SNRT、SACT、房室结前传不应期及文氏点均短于>48 h组(P <0.05);≤48 h组复律后房室结2∶1阻滞点<150次/min患者1例,>48 h组房室结2∶1阻滞点<150次/min患者1例,两组比较差异无统计意义(P> 0.05);≤48 h组复律后长RR间期时间及次数短(少)于>48 h组(P <0.05)。结论 经食管心脏电生理检查用于阵发性房颤合并长RR间期患者能综合评定患者窦房结及房室结功能,具有较高的应用价值,能指导临床诊疗,值得推广应用。Objective To investigate the differences in sinus node and atrioventricular node function among patients with different durations of atrial fibrillation. Methods A total of 50 patients with atrial fibrillation and long RR interval( ≥ 1.5 s) who underwent ambulatory ECG in Meizhou People’s Hospital from February 2019to May 2021 were selected as subjects and divided into two groups according to whether the duration of atrial fibrillation was > 48 h. Patients in the ≤ 48 h group underwent extracorporeal synchronized direct current cardioversion or pharmacological cardioversion, while patients in the > 48 h group underwent anticoagulation for 3 weeks before cardioversion, and digitalis drugs and antiarrhythmic drugs were discontinued after conversion to sinus rhythm. The esophageal electrophysiological test was performed on both groups to compare sinus node function, atrioventricular node anterograde refractory period and Wenckebach cycle length as well as 2 ∶ 1block point in both groups. Results The power of ≤ 48 h group was 84.00%, higher than 64.00% of >48 h group(P < 0.05). The sinus node recovery time(SNRT), sinoatrial conduction time(SACT), atrioventricular nodal refractory period and Venturi point were shorter in ≤ 48 h group than in >48 h group(P < 0.05). There was 1 patient with atrioventricular node 2 ∶ 1 block point <150 times/min in the ≤ 48 h group, and 1 patient with atrioventricular node 2 ∶ 1 block point <150 times/min in the >48 h group, and there was no significant difference between the two groups(P > 0.05). The time and the number of long RR intervals after cardioversion in the ≤ 48 h group were shorter(less) than those in the > 48 h group(P > 0.05). Conclusion The esophageal electrophysiology can comprehensively evaluate the sinus node and atrioventricular node function of patients with paroxysmal atrial fibrillation and long RR interval, which is of high application value and can guide clinical diagnosis and treatment.

关 键 词：食管心脏电生理 阵发性房颤 长RR间期 窦房结功能 

分 类 号：R541.7[医药卫生—心血管疾病]