双腔起搏器植入术后发生心房颤动的相关临床分析  

Clinical analysis of atrial fibrillation after double chamber pacemaker implantation

作　　者：王帆 杨倩[1] 张飞飞[1] 李鑫柠[1] 宋学莲 齐晓勇[1] 李英肖[1] 党懿[1] Wang Fan;Yang Qian;Zhang Feifei;Li Xinning;Song Xuelian;Qi Xiaoyong;Li Yingxiao;Dang Yi(Department of Cardiology,Hebei General Hospital,Shijiazhuang 050000,China;不详)

机构地区：[1]河北省人民医院心血管内科,石家庄市050000

出　　处：《中国循证心血管医学杂志》2024年第7期798-800,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河北省医学科学研究课题(20220854)。

摘　　要：目的探讨双腔起搏器植入术后发生心房颤动的相关影响因素。方法回顾性分析2016年1月至2018年12月于河北省人民医院行永久性双腔心脏起搏器植入,并已完成规律随访1年的429例病例的临床资料和随访资料,其中130例患者存在心房颤动发作(心房颤动组),299例患者无心房颤动发作(对照组),收集患者基本临床资料、术前心脏超声参数、术前及随访期间内长期服用药物,并读取随访时程控仪内存储信息,记录心房高频事件持续时间及心房心室起搏比例。结果心房颤动组患者年龄较对照组大[(76.92±8.68)岁vs.(64.62±10.01)岁,P=0.004],男性占比较高(56.92%vs.45.48%,P=0.029),伴有冠状动脉粥样硬化性心脏病(冠心病)、高血压患者较多,左心房内径较对照组大[(40.45±9.13)mm vs.(38.22±7.95)mm,P=0.045],心房起搏比例、心房电极阻抗高于对照组(P<0.05),进一步Logistic回归分析发现年龄(OR=1.011,95%CI:1.134~1.216)、男性(OR=1.572,95%CI:1.031~2.396)及心房起搏比例较高(OR=1.021,95%CI:1.011~1.032)与心房颤动的发生有关(P<0.05)。结论年龄、男性及心房起搏比例高是双腔起搏器植入术后发生心房颤动的危险因素。Objective To investigate the related factors of atrial fibrillation after double chamber pacemaker implantation.Methods A retrospective analysis was conducted on the clinical data and follow-up data of 429 patients who underwent permanent dual-chamber pacemaker implantation at Hebei General Hospital from January 2016 to December 2018 and completed regular one-year follow-ups.Among these,130 patients experienced episodes of atrial fibrillation(atrial fibrillation group),while 299 patients did not exhibit atrial fibrillation(control group).Basic clinical data and preoperative cardiac ultrasound parameters were collected for all patients.Additionally,data on long-term medication usage prior to and during the follow-up period were gathered.Information stored in the pacemaker's programmer during follow-up was accessed,recording the duration of atrial high-frequency events and the atrial-ventricular pacing ratio.Results Patients in atrial fibrillation group were significantly older(mean age 76.92±8.68 years vs.64.62±10.01 years,P=0.004).and predominantly male(56.92%vs.45.48%,P=0.029).A higher incidence of coronary heart disease and hypertension was observed among these patients.Additionally,the inner diameter of left atrium was larger in the atrial fibrillation group compared to the control group(40.45±9.13 mm vs.38.22±7.95 mm,P=0.045).Both the atrial pacing ratio and atrial electrode impedance were found to be significantly higher in the atrial fibrillation group(P<0.05).Further Logistic regression analysis revealed that the older age(OR=1.011,95%CI:1.134~1.216),male(OR=1.572,95%CI:1.031~2.396)and a higher atrial pacing ratio(OR=1.021,95%CI:1.011~1.032)were significantly associated with the occurrence of atrial fibrillation(P<0.05).Conclusion Age,male gender and high atrial pacing ratio are risk factors for atrial fibrillation after dual chamber pacemaker implantation.

关 键 词：心房颤动 双腔起搏器 临床分析 

分 类 号：R541.75[医药卫生—心血管疾病]