环肺静脉前庭电隔离对阵发性心房颤动患者消融术后心率的影响.docVIP

环肺静脉前庭电隔离对阵发性心房颤动患者消融术后心率的影响 陶四明 郑甲林 李建美 魏巍 杨志刚 洪云飞 张新金 张仪坚 [摘 要] 目的 对比观察阵发性房颤射频消融术前后窦性心率变化，探讨环肺静脉前庭电隔离对迷走神经作用的影响。方法 入选阵发性房颤患者93例，入院完善相关检查，行环肺静脉前庭电隔离消融术。术前、术后1周、3个月、12个月做动态心电图检测患者心率的相关指标并统计对比分析。结果 ①术前、术后1周、3个月、12个月MaxHR、MinHR、MeanHR比较，分别为F=1.874，P=0.137，F=4.909，P=0.003，F=5.136，P=0.003，其中MinHR与MeanHR有统计学差异，组间两两比较，术前与术后1周比较后两者有统计学差异；②术前、术后1周、3个月、12个月时域指标SDNN、 RMSSD、pNN50比较，分别为F=7.384，P=0.000，F=5.607，P=0.002，F=10.23，P=0.000，有统计学差异，组间两两比较，术前与术后1周比较三者均有统计学差异；③术前、术后1周、3个月、12个月频域指标LF、HL、LF/HF比较，分别为F=3.377，P=0.027，F=2.941，P=0.040，F=2.414，P=0.061，其中LF、HL有统计学差异，组间两两比较，术前与术后1周比较前两者有统计学差异。结论 阵发性房颤射频消融术后，部分患者会出现短期内心率增快，心率变异性降低，3个月后逐渐恢复到术前水平。提示肺静脉前庭电隔离在一定程度上达到左房去除迷走神经作用，损伤了房颤的发病基质。 [关键词] 心房颤动；心率变异性；去迷走神经；射频消融 The effect left atrium circumferential pulmonary vein ablation on heart rate of patients with paroxysmal atrial fibrillation TAO Si-ming, ZHENG Jia-lin, LI Jian-mei, et al. Department of Cardiology, The Second Peoples Hospital of YunNan province, Kunming, 650021. Corresponding author: ZHENG Jia-lin, Email:zhengjl163_com@163.com. [Abstract] Objectives To investigate the effect of vagal denervation on heart rate of patients with paroxysmal atrial fibrillation by catheter ablation. Methods Selected 93 patients with paroxysmal atrial fibrillation, preoperative all patients to do relevant examination. Then, to circumferential pulmonary vein isolation ablation. Preoperative, postoperative 1 week, 3 months, 12 months to do the dynamic electrocardiogram with heart rate related parameters. Statistical analysis. Results ①Preoperative, postoperative 1 week, 3 months, 12 months MaxHR, MinHR, MeanHR comparison, F=1.874, P=0.137, F=4.909, P=0.003, F=5.136, P=0.003, MinHR and MeanHR, P0.05 statistically significant, comparison between groups, preoperative and postoperative 1 week was statistically significant; ②Preoperative, postoperative 1 week, 3 months, 12 months time domain SDNN, RMSSD, pNN50 comparison, F=7.384, P=0.000, F=5.607, P=0.002, F=10.23, P=0.000, P0.05 statistical