中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2010年
6期
417-420
,共4页
赵文雪%杨兵%陈明龙%居维竹%陈红武%翟立上%张凤祥%雍永宏%单其俊%邹建刚%陈椿%侯小锋%曹克将
趙文雪%楊兵%陳明龍%居維竹%陳紅武%翟立上%張鳳祥%雍永宏%單其俊%鄒建剛%陳椿%侯小鋒%曹剋將
조문설%양병%진명룡%거유죽%진홍무%적립상%장봉상%옹영굉%단기준%추건강%진춘%후소봉%조극장
心房颤动%左心房压%导管消融%复发
心房顫動%左心房壓%導管消融%複髮
심방전동%좌심방압%도관소융%복발
Atrial fibrillation%Left atrial pressure%Catheter ablation%Recurrence
目的 心房颤动(房颤)消融术中测量左心房压(LAP),研究不同类型房颤患者LAP的变化,探讨LAP与消融术后房颤复发的关系.方法 106例初次行房颤导管消融的患者,分为阵发性房颤(Paro-AF)组(62例)和非阵发性房颤(Non-Paro-AF)组(44例),消融术前1 d行超声心动图检查.消融术中通过心导管术测量LAP:Paro-AF组先记录初始窦性心律时LAPSNR,其中46例患者诱发出持续时间＞3 min的房颤,记录诱发房颤3 min时LAP3min.Non-Paro-AF组记录初始房颤节律下的LAPNon-paro-AF.结果 Non-Paro-AF组LAPNon-paro-AF高于Paro-AF组初始窦性心律下LAPSNR[(21.77±8.72)mm Hg对(14.40±7.77)mm Hg,P＜0.01].Paro-AF组LAP3min高于LAPSNR[(18.30±8.62)mmHg对(13.33±6.55)mm Hg,P＜0.01],但仍然明显低于LAPNon-Paro-AF[(18.30±8.62)mm Hg对(21.77±8.72)mm Hg,P＜0.01].平均随访(14.15±1.75)个月共有32例(30.19%)患者复发,复发患者LAP测量值显著高于未复发者[(23.56±11.30)mm Hg对(14.82±6.06)mm Hg,P＜0.01].单因素回归分析显示左心房内径(LAD)增大、LAP增高和房颤类型是复发的相关因素,多因素回归分析提示LAP和LAD为房颤消融术后复发的独立预测因素.结论 阵发性房颤患者房颤节律下LAP高于窦性心律下LAP,持续性和永久性房颤患者LAP高于阵发性房颤患者.LAP是房颤消融术后复发的独立危险因素之一.
目的 心房顫動(房顫)消融術中測量左心房壓(LAP),研究不同類型房顫患者LAP的變化,探討LAP與消融術後房顫複髮的關繫.方法 106例初次行房顫導管消融的患者,分為陣髮性房顫(Paro-AF)組(62例)和非陣髮性房顫(Non-Paro-AF)組(44例),消融術前1 d行超聲心動圖檢查.消融術中通過心導管術測量LAP:Paro-AF組先記錄初始竇性心律時LAPSNR,其中46例患者誘髮齣持續時間＞3 min的房顫,記錄誘髮房顫3 min時LAP3min.Non-Paro-AF組記錄初始房顫節律下的LAPNon-paro-AF.結果 Non-Paro-AF組LAPNon-paro-AF高于Paro-AF組初始竇性心律下LAPSNR[(21.77±8.72)mm Hg對(14.40±7.77)mm Hg,P＜0.01].Paro-AF組LAP3min高于LAPSNR[(18.30±8.62)mmHg對(13.33±6.55)mm Hg,P＜0.01],但仍然明顯低于LAPNon-Paro-AF[(18.30±8.62)mm Hg對(21.77±8.72)mm Hg,P＜0.01].平均隨訪(14.15±1.75)箇月共有32例(30.19%)患者複髮,複髮患者LAP測量值顯著高于未複髮者[(23.56±11.30)mm Hg對(14.82±6.06)mm Hg,P＜0.01].單因素迴歸分析顯示左心房內徑(LAD)增大、LAP增高和房顫類型是複髮的相關因素,多因素迴歸分析提示LAP和LAD為房顫消融術後複髮的獨立預測因素.結論 陣髮性房顫患者房顫節律下LAP高于竇性心律下LAP,持續性和永久性房顫患者LAP高于陣髮性房顫患者.LAP是房顫消融術後複髮的獨立危險因素之一.
목적 심방전동(방전)소융술중측량좌심방압(LAP),연구불동류형방전환자LAP적변화,탐토LAP여소융술후방전복발적관계.방법 106례초차행방전도관소융적환자,분위진발성방전(Paro-AF)조(62례)화비진발성방전(Non-Paro-AF)조(44례),소융술전1 d행초성심동도검사.소융술중통과심도관술측량LAP:Paro-AF조선기록초시두성심률시LAPSNR,기중46례환자유발출지속시간＞3 min적방전,기록유발방전3 min시LAP3min.Non-Paro-AF조기록초시방전절률하적LAPNon-paro-AF.결과 Non-Paro-AF조LAPNon-paro-AF고우Paro-AF조초시두성심률하LAPSNR[(21.77±8.72)mm Hg대(14.40±7.77)mm Hg,P＜0.01].Paro-AF조LAP3min고우LAPSNR[(18.30±8.62)mmHg대(13.33±6.55)mm Hg,P＜0.01],단잉연명현저우LAPNon-Paro-AF[(18.30±8.62)mm Hg대(21.77±8.72)mm Hg,P＜0.01].평균수방(14.15±1.75)개월공유32례(30.19%)환자복발,복발환자LAP측량치현저고우미복발자[(23.56±11.30)mm Hg대(14.82±6.06)mm Hg,P＜0.01].단인소회귀분석현시좌심방내경(LAD)증대、LAP증고화방전류형시복발적상관인소,다인소회귀분석제시LAP화LAD위방전소융술후복발적독립예측인소.결론 진발성방전환자방전절률하LAP고우두성심률하LAP,지속성화영구성방전환자LAP고우진발성방전환자.LAP시방전소융술후복발적독립위험인소지일.
Objective To investigate the role of left atrial pressure (LAP) in different type of atrial fibrillation (AF) and recurrence of atrial arrhythmia in patients with AF who underwent catheter ablation. Methods Among the 106 patients included in this study, 62 of them had paroxysmal AF (Paro-AF group), and 44 had persistent or permanent AF ( Non-Paro-AF group). LAP of Paro-AF group was evaluated at sinus rhythm ( LAPSNR ) and three minutes after AF was induced ( LAP3 min ). LAPNon-Paro-AF of Non-Paro-AF group was measured at baseline during the procedure. Results LAPsNR in Paro-AF group was significantly lower than LAPNon-Paro-AF in Non-Paro-AF group [ ( 14. 40 ± 7.77) mm Hg vs(21.77 ± 8.72) mm Hg, P ＜0. 01 ].In a subgroup patients with Paro-AF whose AF could be induced and maintained more than three minutes,LAP3 min was significantly increased [ ( 13.33 ± 6.55 ) mm Hg vs( 18. 30 ± 8.62 ) mm Hg, P ＜ 0. 01 ], but it was also lower than LAPNon-Parn-AF[ ( 18.30 ± 8. 62 ) mm Hg vs ( 21.77 ± 8. 72 ) mm Hg, P ＜ 0. 01 ]. After amean follow-up of( 14. 15 ± 1.75) months, 32(30. 19% )patients had recurrent atrial arrhythmia in two groups,LAP level was higher in patients with recurrence than those without recurrence [ (23.56 ± 11.30 ) mm Hg vs( 14. 82 ± 6. 06) mm Hg, P ＜ 0. 01 ]. Multivariate Logistic analysis demonstrated that only LAP and LAD were the independent predictor factor for the recurrence among the variables of age, sex, types of AF, LAD, LAP,left ventricular ejection fraction, thickness of left ventricular posterior wall, thickness of interventricular septum, existence of hypertension. Conclusion The LAP was significantly increased after AF was induced in patients with Paro-AF. The LAP was significantly higher in patients with Non-Paro-AF than those with ParoAF. The increased LAP was one of the independent factors for the recurrence of atrial arrhythmia in patients with catheter ablation.
