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有症状的房室结折返性心动过速和预激综合征患者的性别与房室传导特性

Gender and atrioventricular conduction properties of patients with symptomatic atrioventricular nodal reentrant tachycardia and Wolff-Parkinson-White syndrome.

作者信息

Liu S, Yuan S, Hertervig E, Kongstad O, Olsson S B

机构信息

Department of Cardiology, University Hospital, Lund University, S-221 85 Lund, Sweden.

出版信息

J Electrocardiol. 2001 Oct;34(4):295-301. doi: 10.1054/jelc.2001.26316.

Abstract

The objective of this study was to delineate the sex distribution and atrioventricular conduction properties in patients with manifest or concealed Wolff-Parkinson-White syndrome (WPW) and atrioventricular nodal reentrant tachycardia (AVNRT). The study comprised 328 patients with AVNRT, 347 with manifest, and 220 with concealed WPW who underwent radiofrequency ablation. A male preponderance was observed in patients with manifest WPW (69%), but not in those with concealed WPW (52%) and female preponderance in AVNRT patients (67%). The PR (166 +/- 25 ms) and AH (88 +/- 20 ms) intervals obtained 30 minutes after ablation in manifest WPW patients were significantly longer than in concealed WPW patients (149 +/- 20, 76 +/- 15 ms, P <.0001). The PR (146 +/- 20 ms) and AH intervals (75 +/- 15 ms) measured before ablation in AVNRT patients were shorter than those obtained before ablation in concealed WPW patients (154 +/- 21, 80 +/- 17 ms, P <.05) and after ablation in manifest WPW patients (P <.0001). The PR interval in AVNRT patients was also shorter than those measured during follow-up in concealed (153 +/- 21 ms, P <.05) and manifest WPW patients (165 +/- 23 ms, P <.0001). The ventriculoatrial block cycle length in AVNRT patients was significantly shorter than in manifest and concealed WPW patients. When age-matched patients were assigned to each group, significant differences in PR interval were observed between men and women (159 +/- 22 vs. 151 +/- 22 ms, P <.0001). Differences in sex distribution exist among patients with manifest and concealed WPW and AVNRT. The atrioventricular conduction properties required for the manifestation of pre-excitation and induction of AVNRT and gender differences in atrioventricular conduction may account for the differences in sex distribution.

摘要

本研究的目的是明确显性或隐匿性 Wolff-Parkinson-White 综合征(WPW)及房室结折返性心动过速(AVNRT)患者的性别分布及房室传导特性。该研究纳入了 328 例 AVNRT 患者、347 例显性 WPW 患者和 220 例隐匿性 WPW 患者,所有患者均接受了射频消融治疗。在显性 WPW 患者中观察到男性占优势(69%),而在隐匿性 WPW 患者中并非如此(52%),AVNRT 患者中女性占优势(67%)。显性 WPW 患者消融后 30 分钟测得的 PR 间期(166±25 毫秒)和 AH 间期(88±20 毫秒)显著长于隐匿性 WPW 患者(149±20、76±15 毫秒,P<.0001)。AVNRT 患者消融前测得的 PR 间期(146±20 毫秒)和 AH 间期(75±15 毫秒)短于隐匿性 WPW 患者消融前(154±21、80±17 毫秒,P<.05)及显性 WPW 患者消融后(P<.0001)测得的数值。AVNRT 患者的 PR 间期也短于隐匿性 WPW 患者(153±21 毫秒,P<.05)及显性 WPW 患者随访期间(165±23 毫秒,P<.0001)测得的数值。AVNRT 患者的室房阻滞周期长度显著短于显性和隐匿性 WPW 患者。当将年龄匹配的患者分配到每组时,男性和女性之间的 PR 间期存在显著差异(159±22 与 151±22 毫秒,P<.0001)。显性和隐匿性 WPW 及 AVNRT 患者之间存在性别分布差异。预激表现和 AVNRT 诱发所需的房室传导特性以及房室传导的性别差异可能解释了性别分布的差异。

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