Michelucci A, Lazzeri C, Padeletti L, Bagliani G, Colella A, Sabini A, Zipoli R, Costoli A, Pieragnoli P, Gensini G F, Franchi F
Department of Internal Medicine, University of Florence, Italy.
Ital Heart J. 2001 Jun;2(6):435-40.
It has not so far been elucidated whether the autonomic nervous system plays a role in the pathogenesis of atrial fibrillation relapse after electrical cardioversion.
In 40 consecutive patients with atrial fibrillation (22 males, 18 females, mean age 60 +/- 2 years) submitted to successful electrical cardioversion (external in 26 and low-energy internal in 14) we evaluated the heart rate variability (24-hour Holter recording) immediately after restoration of sinus rhythm in order to assess the cardiac sympatho-vagal drive.
Patients with atrial fibrillation relapse within the first week of electrical cardioversion were characterized by a significantly higher low/high frequency ratio.
Despite the heterogeneity of the studied population (concerning both the therapy and etiology of atrial fibrillation), our data strongly suggest that the evaluation of the low/high frequency ratio by means of power spectral analysis immediately after electrical cardioversion is a useful tool for the identification of those patients who are prone to atrial fibrillation recurrence. Our conclusions are supported by the finding of high positive and negative predictive values for the low/high frequency ratio both in the 24-hour period and during daytime.
迄今为止，自主神经系统是否在电复律后房颤复发的发病机制中起作用尚未阐明。
在40例连续的房颤患者（22例男性，18例女性，平均年龄60±2岁）中，这些患者均成功接受了电复律（26例为体外电复律，14例为低能量体内电复律），我们在窦性心律恢复后立即评估心率变异性（24小时动态心电图记录），以评估心脏交感-迷走神经驱动力。
在电复律后第一周内出现房颤复发的患者，其低频/高频比值显著更高。
尽管所研究人群存在异质性（涉及房颤的治疗和病因），但我们的数据强烈表明，电复律后立即通过功率谱分析评估低频/高频比值是识别那些易于房颤复发患者的有用工具。我们的结论得到以下发现的支持：低频/高频比值在24小时期间及白天均具有较高的阳性和阴性预测值。
