中华老年多器官疾病杂志
中華老年多器官疾病雜誌
중화노년다기관질병잡지
CHINESE JOURNAL OF MULTIPLE ORGAN DISEASES IN THE ELDERLY
2013年
7期
511-514
,共4页
黄立萍%董颖雪%常栋%丛培鑫%王楠%石佳月%高连君%张树龙%杨延宗%林治湖
黃立萍%董穎雪%常棟%叢培鑫%王楠%石佳月%高連君%張樹龍%楊延宗%林治湖
황립평%동영설%상동%총배흠%왕남%석가월%고련군%장수룡%양연종%림치호
阵发性心房颤动%心率变异性%环肺静脉消融
陣髮性心房顫動%心率變異性%環肺靜脈消融
진발성심방전동%심솔변이성%배폐정맥소융
paroxysmal atrial fibrillation%heart rate variability%circumferential pulmonary vein ablation
目的评价环肺静脉消融（CPVA）对阵发性心房颤动（PAF）患者自主神经功能及其预后的影响。方法连续入选2011年1月至2011年12月就诊的接受CPVA的PAF患者110例[年龄（59.07±11.54）岁，男67例，女43例]，患者均接受CPVA至肺静脉电隔离。分别于消融前及术后第2天行动态心电图检查，观察心率变异性（HRV）时域指标变化及其对消融效果的影响。结果随访14.46±5.57个月，心房颤动（AF）消融成功率为72.45%（71/98）。完成随访的98例患者中，AF无复发71例，设为消融成功组（男45例、女26例）；复发27例，设为消融复发组（男15例、女12例）。两组消融前HRV相似，消融后HRV显著降低（P＜0.05）；消融成功组HRV均较消融复发组进一步显著降低（P＜0.05）。结论CPVA使HRV显著降低，产生去自主神经效应，这可能是CPVA治疗PAF的机制之一。增加去神经效应对PAF消融长期成功率有一定影响，明确了AF射频消融与HRV之间的关系。
目的評價環肺靜脈消融（CPVA）對陣髮性心房顫動（PAF）患者自主神經功能及其預後的影響。方法連續入選2011年1月至2011年12月就診的接受CPVA的PAF患者110例[年齡（59.07±11.54）歲，男67例，女43例]，患者均接受CPVA至肺靜脈電隔離。分彆于消融前及術後第2天行動態心電圖檢查，觀察心率變異性（HRV）時域指標變化及其對消融效果的影響。結果隨訪14.46±5.57箇月，心房顫動（AF）消融成功率為72.45%（71/98）。完成隨訪的98例患者中，AF無複髮71例，設為消融成功組（男45例、女26例）；複髮27例，設為消融複髮組（男15例、女12例）。兩組消融前HRV相似，消融後HRV顯著降低（P＜0.05）；消融成功組HRV均較消融複髮組進一步顯著降低（P＜0.05）。結論CPVA使HRV顯著降低，產生去自主神經效應，這可能是CPVA治療PAF的機製之一。增加去神經效應對PAF消融長期成功率有一定影響，明確瞭AF射頻消融與HRV之間的關繫。
목적평개배폐정맥소융（CPVA）대진발성심방전동（PAF）환자자주신경공능급기예후적영향。방법련속입선2011년1월지2011년12월취진적접수CPVA적PAF환자110례[년령（59.07±11.54）세，남67례，녀43례]，환자균접수CPVA지폐정맥전격리。분별우소융전급술후제2천행동태심전도검사，관찰심솔변이성（HRV）시역지표변화급기대소융효과적영향。결과수방14.46±5.57개월，심방전동（AF）소융성공솔위72.45%（71/98）。완성수방적98례환자중，AF무복발71례，설위소융성공조（남45례、녀26례）；복발27례，설위소융복발조（남15례、녀12례）。량조소융전HRV상사，소융후HRV현저강저（P＜0.05）；소융성공조HRV균교소융복발조진일보현저강저（P＜0.05）。결론CPVA사HRV현저강저，산생거자주신경효응，저가능시CPVA치료PAF적궤제지일。증가거신경효응대PAF소융장기성공솔유일정영향，명학료AF사빈소융여HRV지간적관계。
Objective To evaluate the therapeutic effects of circumferential pulmonary vein ablation (CPVA) on the autonomic nerve function and prognosis of patients with paroxysmal atrial fibrillation (PAF). Methods A total of 110 consecutive patients with symptomatic and drug refractory PAF [age of (59.07±11.54) years, 67 males and 43 females] undergoing CPVA in our department from January to December 2011 were enrolled in this study. They all received pulmonary vein isolation (PVI) during CPVA. The time-domain analyses of heart rate variability (HRV) were obtained by 24-hour Holter monitoring before and at 2 days after ablation, and the efficacy of CPVA was evaluated and analyzed according to the changes of HRV. Results After the follow-up of (14.46±5.57) months, the success rate for atrial fibrillation (AF) was 72.45%for 98 patients who finished the study. According to the outcome, these patients were divided into 2 groups, success group (n=71, 45 males and 26 females) and recurrence group (n=27, 15 males and 12 females). Before ablation, there was no difference in HRV indices between the success group and recurrence group. After ablation, HRV indices were decreased significantly in both groups (P<0.05), with those in success group dramatically lower than those in recurrence group (P<0.05). Conclusions CPVA significantly reduces HRV and induces autonomic dysfunction, which may be one of the underlying mechanisms of its treatment for PAF. Enhancing denervation has effects on the long-term success of PAF ablation. These results identify the relationship between AF ablation and HRV.
