心房颤动期间的心室停搏可预测电复律后的复发：一项前瞻性研究。

Ventricular pauses during atrial fibrillation predict relapse after electrical cardioversion: a prospective study.

作者信息

Gallagher Mark Michael, Guo Xiao Hua, Poloniecki Jan, Camm A John

机构信息

Division of Cardiac & Vascular Sciences, St George's Hospital, University of London, London, United Kingdom.

出版信息

Pacing Clin Electrophysiol. 2010 Aug;33(8):934-8. doi: 10.1111/j.1540-8159.2010.02755.x. Epub 2010 May 4.

DOI:10.1111/j.1540-8159.2010.02755.x

PMID:20487347

Abstract

AIMS

To investigate the use of ambulatory electrocardiogram (ECG) monitoring in atrial fibrillation (AF) to predict recurrence after electrical cardioversion (ECV).

METHODS

RR interval variables were obtained from 24 hours ECGs recorded before ECV in 119 patients (85 men, age 66 +/- 10 years) with persistent AF. Patients were followed for 1 month.

RESULTS

Of the 119 patients, 16 (13%) failed ECV and 65 (55%) were in AF at 1 week and 81 (68%) at 1 month after ECV. The maximum RR interval (RR-max) and the minimum RR interval (RR-min) during AF were found to be reproducible. The RR-max was longer in those who had AF 1 week (2.55 +/- 0.49 vs 2.01 +/- 0.52 seconds, P = 0.005) and 1 month (2.56 +/- 0.50 vs 1.89 +/- 0.43 ms; P < 0.001) after ECV than in those who maintained sinus rhythm. Those in AF at 1 month included more patients with RR-max > or = 2.8 seconds (31% vs 11% P = 0.021). The average heart rate was lower in patients with RR-max > or = 2.8 seconds, but the average rate was not predictive of AF recurrence.

CONCLUSION

Ventricular pauses during AF predict relapse after ECV.

摘要

目的

研究动态心电图监测在心房颤动（房颤）患者中对预测电复律（ECV）后复发情况的应用。

方法

从119例（85例男性，年龄66±10岁）持续性房颤患者ECV前记录的24小时心电图中获取RR间期变量。对患者随访1个月。

结果

119例患者中，16例（13%）ECV失败，65例（55%）在ECV后1周时处于房颤状态，81例（68%）在ECV后1个月时处于房颤状态。房颤期间的最大RR间期（RR-max）和最小RR间期（RR-min）具有可重复性。与维持窦性心律的患者相比，在ECV后1周（2.55±0.49秒对2.01±0.52秒，P = 0.005）和1个月（2.56±0.50对1.89±0.43毫秒；P < 0.001）时处于房颤状态的患者RR-max更长。1个月时处于房颤状态的患者中，RR-max≥2.8秒的患者更多（31%对11%，P = 0.021）。RR-max≥2.8秒的患者平均心率较低，但平均心率不能预测房颤复发。