Gribbin G M, Bourke J P, McComb J M
Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, UK.
Heart. 1998 Jun;79(6):548-53. doi: 10.1136/hrt.79.6.548.
To assess the natural history of the atrial rhythm of patients with paroxysmal atrial arrhythmias undergoing atrioventricular node ablation and permanent pacemaker implantation.
A retrospective cohort study of consecutive patients identified from the pacemaker database and electrophysiology records of a tertiary referral hospital.
62 consecutive patients with paroxysmal atrial arrhythmias undergoing atrioventricular node ablation and permanent pacemaker implantation between 1988 and July 1996.
(1) Atrial rhythm on final follow up ECG, classified as either ordered (sinus rhythm or atrial pacing) or disordered (atrial fibrillation, atrial flutter or atrial tachycardia). (2) Chronic atrial fibrillation, defined as a disordered rhythm on two consecutive ECGs (or throughout a 24 hour Holter recording) with no ordered rhythm subsequently documented.
Survival analysis showed that 75% of patients progressed to chronic atrial fibrillation by 2584 days (86 months). On multiple logistic regression analysis a history of electrical cardioversion, increasing patient age, and VVI pacing were associated with the development of chronic atrial fibrillation. A history of electrical cardioversion and increasing patient age were associated with a disordered atrial rhythm on the final follow up ECG.
Patients with paroxysmal atrial arrhythmias are at high risk of developing chronic atrial fibrillation. A history of direct current cardioversion.
评估接受房室结消融和永久性起搏器植入术的阵发性房性心律失常患者的房性心律自然史。
一项回顾性队列研究，研究对象为从一家三级转诊医院的起搏器数据库和电生理记录中确定的连续患者。
1988年至1996年7月期间连续62例接受房室结消融和永久性起搏器植入术的阵发性房性心律失常患者。
（1）最后一次随访心电图上的房性心律，分为有序（窦性心律或心房起搏）或无序（心房颤动、心房扑动或房性心动过速）。（2）慢性心房颤动，定义为连续两次心电图（或整个24小时动态心电图记录）上的无序心律，且随后未记录到有序心律。
生存分析显示，75%的患者在2584天（86个月）时进展为慢性心房颤动。多因素logistic回归分析显示，电复律病史、患者年龄增加和VVI起搏与慢性心房颤动的发生有关。电复律病史和患者年龄增加与最后一次随访心电图上的无序房性心律有关。
阵发性房性心律失常患者发生慢性心房颤动的风险很高。直流电复律病史。
