Chong James J H, Kumar Saurabh, Thomas Liza, Thomas Stuart
Department of Cardiology, Westmead Hospital, Cnr Hawkesbury and Darcy Rds, Westmead NSW 2145, Australia.
Europace. 2006 May;8(5):341-4. doi: 10.1093/europace/eul008.
Paroxysmal atrial fibrillation (AF) is usually preceded by a premature atrial complex (PAC). We hypothesized that patients with a high frequency of atrial ectopic activity after restoration of sinus rhythm following direct current cardioversion would be more likely to experience recurrence of AF.
Forty-four patients with documented persistent AF were studied. A 24 h Holter recording was performed from the day of external direct current cardioversion. Patients were reviewed at 1 week, 1 month, and 6 months. After 6 months, 59% of patients had experienced a recurrence of AF. Neither the frequency of PACs nor the frequency or duration of supraventricular tachycardia (SVT) episodes predicted AF recurrence (P=0.60, 0.30, and 0.42, respectively). There was a trend towards maximum rate of SVT predicting recurrence of AF (P=0.08).
Frequency of supraventricular ectopy or the number and length of SVT runs in the 24 h after restoration of sinus rhythm are not strong predictors of recurrence of AF after electrical cardioversion. A larger study would be required to detect a small predictive effect.
阵发性心房颤动（AF）通常在房性早搏（PAC）之前出现。我们假设，直流电复律后窦性心律恢复后心房异位活动频率高的患者更有可能经历房颤复发。
对44例记录有持续性房颤的患者进行了研究。从体外直流电复律当天开始进行24小时动态心电图记录。在1周、1个月和6个月时对患者进行复查。6个月后，59%的患者经历了房颤复发。PAC的频率、室上性心动过速（SVT）发作的频率或持续时间均不能预测房颤复发（P分别为0.60、0.30和0.42）。SVT的最大心率有预测房颤复发的趋势（P=0.08）。
窦性心律恢复后24小时内室上性异位搏动的频率或SVT发作的次数和时长并不是电复律后房颤复发的有力预测指标。需要进行更大规模的研究来检测微小的预测效应。
