中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2011年
3期
221-224
,共4页
居维竹%陈明龙%杨兵%陈红武%张凤祥%翟立上%侯小锋%陈椿%邹建刚%单其俊%曹克将
居維竹%陳明龍%楊兵%陳紅武%張鳳祥%翟立上%侯小鋒%陳椿%鄒建剛%單其俊%曹剋將
거유죽%진명룡%양병%진홍무%장봉상%적립상%후소봉%진춘%추건강%단기준%조극장
心房颤动%心率变异性%导管消融
心房顫動%心率變異性%導管消融
심방전동%심솔변이성%도관소융
Atrial fibrillation%Heart rate variability%Catheter ablation
目的 观察环肺静脉口部消融隔离治疗阵发性心房颤动(AF)术后心率及心率变异性(HRV)时域指标的长期变化.方法 共45例行射频消融术的阵发性AF患者,术前、术后第3天、术后1、3、6个月在本院行24 h动态心电图检查.分别测定平均心率(mean HR),时域指标RR间期标准差(SDNN),RR间期平均值的标准差(SDANN),相邻RR间期差的均方根(RMMSD),相邻RR间期差值超过50 ms的RR间期所占百分数(PNN50).结果 共33例患者的动态心电图资料符合要求而纳入结果分析.其中男23例,女10例,年龄(59±10)岁,左心房直径(35±5)mm,左心室射血分数0.63±0.06.术后3 d,1、3、6个月mean HR较术前增快,差异有统计学意义.而HRV时域指标均出现减弱,部分指标如SDNN、SDANN在6个月时其变化仍然有统计学意义.是否进行右心房峡部消融对心率及HRV指标变化无影响.术中有无明显"去迷走神经"反射者之间差异也无统计学意义.结论 环肺静脉口部消融隔离术后平均心率增快,部分HRV时域指标减弱至少维持6个月.这种对自主神经系统的损伤作用可能是射频消融治疗AF的机制之一.
目的 觀察環肺靜脈口部消融隔離治療陣髮性心房顫動(AF)術後心率及心率變異性(HRV)時域指標的長期變化.方法 共45例行射頻消融術的陣髮性AF患者,術前、術後第3天、術後1、3、6箇月在本院行24 h動態心電圖檢查.分彆測定平均心率(mean HR),時域指標RR間期標準差(SDNN),RR間期平均值的標準差(SDANN),相鄰RR間期差的均方根(RMMSD),相鄰RR間期差值超過50 ms的RR間期所佔百分數(PNN50).結果 共33例患者的動態心電圖資料符閤要求而納入結果分析.其中男23例,女10例,年齡(59±10)歲,左心房直徑(35±5)mm,左心室射血分數0.63±0.06.術後3 d,1、3、6箇月mean HR較術前增快,差異有統計學意義.而HRV時域指標均齣現減弱,部分指標如SDNN、SDANN在6箇月時其變化仍然有統計學意義.是否進行右心房峽部消融對心率及HRV指標變化無影響.術中有無明顯"去迷走神經"反射者之間差異也無統計學意義.結論 環肺靜脈口部消融隔離術後平均心率增快,部分HRV時域指標減弱至少維持6箇月.這種對自主神經繫統的損傷作用可能是射頻消融治療AF的機製之一.
목적 관찰배폐정맥구부소융격리치료진발성심방전동(AF)술후심솔급심솔변이성(HRV)시역지표적장기변화.방법 공45례행사빈소융술적진발성AF환자,술전、술후제3천、술후1、3、6개월재본원행24 h동태심전도검사.분별측정평균심솔(mean HR),시역지표RR간기표준차(SDNN),RR간기평균치적표준차(SDANN),상린RR간기차적균방근(RMMSD),상린RR간기차치초과50 ms적RR간기소점백분수(PNN50).결과 공33례환자적동태심전도자료부합요구이납입결과분석.기중남23례,녀10례,년령(59±10)세,좌심방직경(35±5)mm,좌심실사혈분수0.63±0.06.술후3 d,1、3、6개월mean HR교술전증쾌,차이유통계학의의.이HRV시역지표균출현감약,부분지표여SDNN、SDANN재6개월시기변화잉연유통계학의의.시부진행우심방협부소융대심솔급HRV지표변화무영향.술중유무명현"거미주신경"반사자지간차이야무통계학의의.결론 배폐정맥구부소융격리술후평균심솔증쾌,부분HRV시역지표감약지소유지6개월.저충대자주신경계통적손상작용가능시사빈소융치료AF적궤제지일.
Objective To evaluate the long-term effect of circumferential pulmonary vein isolation (CPVI) on the cardiac automic system using the heart rate and heart rate variability. Methods Forty-five patients referred to catheter ablation for the paroxysmal atrial fibrillation were enrolled in the study. The CPVI at the pulmonary vein ostium was done in every patient. Before the procedure,3 days,1 ,3 ,and 6 months after the procedure,the patient received 24 h ambulatory electrocardiogram monitor ( Holter). The mean heart rate and the time domain analyses of HRV were obtained by the Holter. Results CPVI was successfully done in every patient. Thirty-three patients (23 males) meet the analysis criterion, with mean age of (59±10) years,mean left atrium diameter (35±5) mm,mean left ventricular ejection fraction 0. 63±0.06. Among them,8 patients accepted additional right atrial isthmus ablation,5 patients had suffered from vagal reflex in the procedure. The mean heart rate significantly increased in the post procedure period compared with that before the procedure (P <0.05). Significant 6 months of HRV attenuations were observed in SDNN and SDANN. However,the right atrial isthmus ablation as well as the vagal reflex did not have significant impact on the alteration of the heart rate and HRV. Conclusion CPVI significantly altered the heart rate and HRV in at least 6 months. It suggests that cardiac nervous system damage might be one of the mechanisms of catheter ablation for AF.
