心电图P波参数对房颤患者射频消融术后复发的预测价值  

Predictive value of electrocardiogram P-wave parameters for recurrence after radiofrequency ablation in patients with atrial fibrillation

作　　者：杨茜 张莹 Yang Qian;Zhang Ying(Department of Emergency,Jiujiang First People's Hospital,Jiujiang City,Jiangxi Province,332000,China)

机构地区：[1]九江市第一人民医院急诊二科,江西省九江市332000

出　　处：《现代电生理学杂志》2023年第3期157-160,共4页Journal of Modern Electrophysiology

摘　　要：目的探讨心电图P波参数与房颤患者射频消融术后预后的关系。方法选择九江市第一人民医院2019年1月至2021年10月收治的经12导心电图或动态心电图证实为阵发性房颤患者51例,性别不限,年龄42~75岁,均接受射频消融术治疗,收集临床基线资料及手术前后12导联心电图资料,根据患者预后情况分为预后良好组与预后不良组,记录患者射频消融术前后P波时限(PWD)、最大P波时限(Pmax)和P波离散度(Pd)。并采用logistic回归分析影响房颤患者射频消融术后预后的相关因素。结果51例患者均成功接受射频消融术,术后平均随访9.5个月,无失访者。其中13例预后不良,38例预后良好。术后患者PWD、Pmax、Pd均下降(P<0.001),预后不良组PWD、Pmax、Pd均高于预后良好组(P<0.001)。两组年龄、术前PWD、Pmax以及Pd等比较差异具有统计学意义(P<0.001)。logistic回归分析显示年龄、术前PWD≥150 ms、Pmax≥120 ms、Pd≥50 ms是影响房颤患者射频消融术后预后的影响因素(P<0.05)。结论心电图P波参数中PWD、Pmax、Pd与房颤患者射频消融术后复发存在相关性。Objective To investigate the relationship between ECG P-wave parameters and prognosis after radiofrequency ablation in patients with atrial fibrillation(AF).Methods A total of 51 patients with paroxysmal AF confirmed by 12 lead electrocardiogram or dynamic electrocardiogram admitted to Jiujiang First People's Hospital from January 2019 to October 2021 were enrolled in the study,both of sexes,aged 42-75 years old.All patients received radiofrequency ablation treatment.Clinical data and 12-lead electrocardiogram data before and after surgery were collected.Patients were divided into good prognosis group and poor prognosis group according to the prognosis.P-wave duration(PWD),maximum P-wave duration(Pmax)and P-wave dispersion(Pd)were recorded before and after radiofrequency ablation.Logistic regression analysis was used to analyze the relevant factors affecting the prognosis of patients with AF after radiofrequency ablation.Results All 51 patients successfully underwent radiofrequency ablation and were followed up for an average of 9.5 months without any loss of follow-up.Among them,13 cases had poor prognosis and 38 cases had good prognosis.PWD,Pmax and Pd were decreased after surgery(P<0.001),and PWD,Pmax and Pd in poor prognosis group were higher than those in good prognosis group(P<0.001).There were significant differences in age,preoperative PWD,Pmax and Pd between the two groups(P<0.001).Logistic regression analysis showed that age,preoperative PWD≥150 ms,Pmax≥120 ms and Pd≥50 ms were influencing factors on prognosis of patients with AF after radiofrequency ablation(P<0.05).Conclusion There is a correlation between PWD,Pmax,and Pd and recurrence after radiofrequency ablation in patients with AF.

关 键 词：心房颤动 心电描记术 射频消融 预后 P波 

分 类 号：R541.75[医药卫生—心血管疾病] R540.41[医药卫生—内科学]