CAJ | 학술논문

目的评价房间阻滞对心脏再同步治疗(CRT)术后新发心房颤动(房颤)的影响.方法 69例接受心脏再同步治疗除颤器(CRT-D)的慢性心力衰竭患者根据体表心电图Ⅰ导联或aVL导联或V1导联P波时限及形态,分为:房间阻滞组(17例)、房间传导正常组(52例).术后1、3、6、12个月随访,复查超声心动图(UCG)及24 h动态心电图(DCG),并根据患者术后心功能改善情况决定是否接受超声指导下起搏器优化.结果与房间传导正常组相比,房间阻滞组新发房颤率(41.1％对11.5％,P=0.012)明显增高,而且大多数患者在术后早期(术后1周)即出现新发房颤.此外,房间阻滞组超声指导下起搏器优化率(41.1％对11.5％,P=0.012)也明显增高,并且需要更长的AV/PV间期.结论房间阻滞增加CRT-D术后新发房颤的风险.
목적 평개방간조체대심장재동보치료(CRT)술후신발심방전동(방전)적영향.방법 69례접수심장재동보치료제전기(CRT-D)적만성심력쇠갈환자근거체표심전도Ⅰ도련혹aVL도련혹V1도련P파시한급형태,분위:방간조체조(17례)、방간전도정상조(52례).술후1、3、6、12개월수방,복사초성심동도(UCG)급24 h동태심전도(DCG),병근거환자술후심공능개선정황결정시부접수초성지도하기박기우화.결과 여방간전도정상조상비,방간조체조신발방전솔(41.1％대11.5％,P=0.012)명현증고,이차대다수환자재술후조기(술후1주)즉출현신발방전.차외,방간조체조초성지도하기박기우화솔(41.1％대11.5％,P=0.012)야명현증고,병차수요경장적AV/PV간기.결론 방간조체증가CRT-D술후신발방전적풍험.
Objective The purpose of this study was to evaluate the influence of intra-atrial block (IAB) on the incidence of new onset atrial fibrillation after cardiac resynchronization therapy(CRT).Methods Sixty-nine patients with chronic heart failure underwent cardiac resynchronization therapy defibrillator(CRT-D)were divided into IAB group and non-IAB group according to the P-wave duration and morphology in lead I,lead aVL or lead V1 of electrocardiogram.IAB group:P-wave duration ≥ 120 ms or the distance between two peaks in P-wave(Pd) ≥40 ms;non-IAB group:P-wave duration＜ 120 ms and Pd＜40 ms.UCG and DCG were repeated respectively in 1,3,6,12 months after CRT-D.Whether the patient needs to accept a pacemaker optimization guided by echocardiography depended on the patient' s heart function.Results After 12 months follow-up,compared with the non-IAB group,the incidence of new onset atrial fibrillation after CRT-D in IAB group increased obviously(41.1％ vs 11.5％,P=0.012),and most of new onset atrial fibrillation were found in the early stage (within one week) after CRT-D.Furthermore,the rate of pacemaker optimization guided by echocardiography in IAB group increased significantly (41.1％ vs 11.5％,P =0.012),and a longer AV/PV delay was needed in the patients in IAB group.Conclusion IAB increases the risk of new onset atrial fibrillation after CRT-D.