心电图P波参数P_(d)、P_(max)对心房颤动射频导管消融术预后的预测价值  

Predictive value of ECG P-wave parameters of P_(d)and P_(max)on prognosis of atrial fibrillation after radiofrequency catheter ablation

作　　者：马博文 王亦凡[1] 任园园 张莉[1] MA Bowen;WANG Yifan;REN Yuanyuan;ZHANG Li(Department of ECG Diagnosis,Nanyang Central Hospital,Nanyang Henan 473000,China;Department of Cardiovascular Medicine,Nanyang Central Hospital,Nanyang Henan 473000,China)

机构地区：[1]南阳市中心医院心电诊断科,河南南阳473000 [2]南阳市中心医院心血管内科,河南南阳473000

出　　处：《实用心电学杂志》2024年第5期461-464,共4页Journal of Practical Electrocardiology

摘　　要：目的探讨心电图P波参数对于心房颤动(简称房颤)射频导管消融(radiofrequency catheter ablation,RFCA)术预后的预测价值。方法选择接受RFCA术的70例房颤患者,记录其术前心电图P波离散度(P-wave dispersion,P_(d))、P波最大时限(maximum P-wave duration,P_(max)),根据预后情况(是否复发)分为预后良好组、预后不良组。采用Logistic回归分析,探讨上述心电图P波参数与房颤患者RFCA术后预后的相关性,并使用ROC曲线分析评价P波参数对房颤患者RFCA术预后的预测价值。结果70例房颤患者中,RFCA术后预后不良者30例,预后良好者40例。预后不良组P_(d)、P_(max)均高于预后良好组(均P<0.05);组间其他指标比较,差异均无统计学意义(均P>0.05)。Logistic回归分析结果显示,P_(d)、P_(max)是影响房颤患者RFCA术预后的危险因素(OR>1,P<0.05)。ROC曲线分析显示,P_(d)、P_(max)及其联合指标评估房颤患者RFCA治疗后预后不良风险的AUC值分别为0.751、0.760、0.900。结论心电图P波参数与房颤患者RFCA术预后相关,P_(d)、P_(max)联合检测能提升对其预后的预测效能。Objective To investigate the predictive value of ECG P-wave parameters on the prognosis of atrial fibrillation(AF)after radiofrequency catheter ablation(RFCA).Methods A total of 70 AF patients who had undergone RFCA were selected.The P-wave dispersion(P_(d))and the maximum P-wave duration(Pmax)of their ECGs before operation were recorded.According to the postoperative prognosis(the presence or absence of AF recurrence),they were divided into good prognosis group and poor prognosis group.Logistic regression analysis was used to explore the correlation between P-wave parameters of ECG and prognosis of AF patients after RFCA.ROC curve analysis was utilized to evaluate the predictive value of P-wave parameters on the prognosis of AF patients after RFCA.Results Among the 70 AF patients,30 cases had poor prognosis while 40 cases had good prognosis after RFCA.P_(d) and Pmax in the poor prognosis group were both higher than those in the good prognosis group(both P<0.05).There were no statistically significant differences in other parameters between the two groups(all P>0.05).The results of Logistic regression analysis revealed that P_(d) and Pmax were risk factors influencing the prognosis of AF patients after RFCA(OR>1,P<0.05).The ROC curve analysis showed that the AUC values of P_(d),Pmax and the combined indicators in assessing the risk factors of poor prognosis among AF patients after RFCA were 0.751,0.760 and 0.900,respectively.Conclusion The P-wave parameters of ECG are related to the prognosis of AF patients after RFCA;the combined detection of P_(d) and Pmax could improve the prognostic prediction efficiency.

关 键 词：心房颤动 射频导管消融 心电图P波参数 预后 预测价值 

分 类 号：R541.75[医药卫生—心血管疾病] R540.4[医药卫生—内科学]