心电图MVP积分在阵发性心房颤动射频导管消融术后随访中的临床价值  

The clinical significance of electrocardiogram MVP score in the follow-up of patients after radiofrequency catheter ablation of paroxysmal atrial fibrillation

作　　者：孙娴超 黄玥 王志勇 孔丽娅[3] 胡立群 徐文博 张晓丽 SUN Xianchao;HUANG Yue;WANG Zhiyong;KONG Liya;HU Liqun;XU Wenbo;ZHANG Xiaoli(Electrocardiography,First Hospital of Jiaxing,Jiaxing 314000,China)

机构地区：[1]嘉兴市第一医院(嘉兴大学附属医学院)心电科,314000 [2]嘉兴市第一医院(嘉兴大学附属医学院)心血管内科,314000 [3]浙江中医药大学统计教研室

出　　处：《心电与循环》2024年第2期136-140,共5页Journal of Electrocardiology and Circulation

基　　金：嘉兴市公益性研究计划项目(2020AD30046)。

摘　　要：目的探讨心电图P波形态、电压及时间(MVP)积分在阵发性心房颤动(下称房颤)射频导管消融术(下称消融)后随访中的临床价值。方法选择2018年2月至2022年1月嘉兴市第一医院(嘉兴大学附属医院)收治的心房颤动消融患者84例,随访1年,依据房颤是否复发分为未复发组60例、复发组24例。比较两组患者消融前、消融后1年心电图P波参数(MVP)积分、超声心动图检查指标。结果未复发组消融前患者P波时间、MVP积分小于复发组,P波面积大于复发组,未复发组消融后1年患者P波时间、V_(1)P波负向部分振幅和时间的乘积(PtfV_(1))、P波面积、MVP积分小于复发组,差异均有统计学意义(均P<0.05)。复发组消融后1年PtfV_(1)大于消融前,差异有统计学意义(P<0.05)。心电图P波时间、P波面积、MVP积分是房颤消融后房颤复发的影响因素(均P<0.05)。ROC曲线分析发现,MVP积分诊断房颤复发的AUC较大(P=0.001)。未复发组消融前后左心房前后径(LAD)小于复发组,消融后左心室短轴缩短率、左心室射血分数大于复发组,差异均有统计学意义(均P<0.05)。复发组消融前后MVP积分与LAD均呈正相关(r=0.312、0.381,均P<0.05)。结论心电图MVP积分有助于预测房颤消融后复发。Objective To explore clinical significance of electrocardiogram P wave morphology-voltage-P duration(MVP)score in the follow-up of patients after catheter ablation of paroxysmal atrial fibrillation(AF).Methods A total of 84 AF patients underwent radiofrequency catheter ablation in the First Hospital of Jiaxing from February 2018 to January 2022 were included and followed up for 1 year.AF reoccurred in 24 cases(recurrent group)and not in 60 cases(non-recurrent group).P-wave parameters,MVP scores and echocardiography measurements before and 1 year later after ablation were compared between the two groups.Results P-wave duration and MVP score were significantly lower and P-wave area was significantly higher in the non-recurrent group than in the recurrent group before AF ablation(all P<0.05).P-wave duration,PtfV_(1),P-wave area,and MVP score were significantly lower in the non-recurrent group than in the recurrent group 1 year later after ablation(all P<0.05).PtfV_(1)was significantly higher 1 year later after ablation than before in the recurrent group(P<0.05).P-wave duration,P-wave area and MVP score were the factors influencing AF recurrence(all P<0.05).ROC curve analysis showed in the diagnosis of AF recurrence,the AUC of MVP score was higher(P=0.001).Left atrial diameter before and after ablation in the non-recurrent group were significantly lower than that in the recurrent group,while left ventricular fractional shortening and ejection fraction after ablation were significantly higher than those in the recurrent group(all P<0.05).MVP score was positively related to left atrial diameters pre-and post-ablation in the recurrent group(r=0.312,0.381,both P<0.05).Conclusion ECG MVP score is helpful in predicting AF recurrence after ablation.

关 键 词：心房颤动 射频导管消融术 P波参数 P波形态、电压及时间积分 

分 类 号：R541.75[医药卫生—心血管疾病]