Holmqvist Fredrik, Stridh Martin, Waktare Johan E P, Sörnmo Leif, Olsson S Bertil, Meurling Carl J
Department of Cardiology, Lund University Hospital, Lund, Sweden.
Eur Heart J. 2006 Sep;27(18):2201-7. doi: 10.1093/eurheartj/ehl098. Epub 2006 Sep 6.
The study set out to explore whether an index of atrial electrical electrophysiology can be used to predict atrial fibrillation (AF) relapse, and if the predictive properties differ as a result of arrhythmia duration.
The study comprised 175 consecutive patients with persistent AF (median duration 94 days, range 2 to 1044) referred for cardioversion. Twenty-nine patients had arrhythmia duration under 30 days (median 5 days, range 2-26). Atrial fibrillatory rate (AFR) was estimated using a frequency power spectrum analysis of QRST-cancelled ECG. At 1-month follow-up, 56% of the patients had relapsed to AF. The pre-cardioversion mean AFR of those patients was 399+/-52 fibrillations per minute (fpm) compared with 363+/-63 fpm among patients maintaining SR (P<0.0001). In patients with short AF duration, the difference was even more pronounced (424+/-52 vs. 345+/-65 fpm, P<0.01). In this group, a finding of an AFR above the mean value of the study population predicted AF relapse with high accuracy.
In patients undergoing cardioversion of persistent AF, AF relapse is predicted by a higher AFR. A stronger association is seen in patients with short arrhythmia duration, reflecting either rapid remodelling or pre-existing changes in those who relapse to AF.
本研究旨在探讨心房电生理学指标是否可用于预测房颤（AF）复发，以及预测特性是否因心律失常持续时间而异。
本研究纳入了175例连续的持续性房颤患者（中位持续时间94天，范围2至1044天），这些患者均接受了心脏复律治疗。29例患者的心律失常持续时间在30天以下（中位5天，范围2至26天）。使用去除QRST的心电图频率功率谱分析来估计心房颤动率（AFR）。在1个月的随访中，56%的患者复发为房颤。这些复发患者在心脏复律前的平均AFR为每分钟399±52次颤动（fpm），而维持窦性心律（SR）的患者为363±63 fpm（P<0.0001）。在房颤持续时间短的患者中，差异更为明显（424±52 vs. 345±65 fpm，P<0.01）。在这组患者中，AFR高于研究人群平均值的结果可高度准确地预测房颤复发。
在接受持续性房颤心脏复律的患者中，较高的AFR可预测房颤复发。在心律失常持续时间短的患者中观察到更强的相关性，这反映了快速重塑或复发为房颤患者的既往存在的变化。
