Department of Cardiology, Center for Integrative Electrocardiology at Lund University (CIEL), Lund, Sweden.
Europace. 2013 Oct;15(10):1445-52. doi: 10.1093/europace/eut057. Epub 2013 Mar 20.
Atrial fibrillatory rate (AFR) is considered a non-invasive index of atrial remodelling. Low AFR has been associated with favourable outcome of interventions in patients with persistent atrial fibrillation (AF). However, AFR has never been studied in unselected patients with short duration of AF, prone to regain sinus rhythm (SR) spontaneously. The aim of the study was to assess if AFR can predict spontaneous conversion in patients with recent-onset AF.
Files of consecutive patients with AF < 48 h seeking emergency room care during a 12-month period were screened (n = 225). Patients with thyroid illness, acute ischaemic heart disease (IHD) or acute congestive heart failure, significant valvular heart disease, congenital heart disease, history of cardiac surgery or catheter ablation, or on class I/III antiarrhythmics were excluded. Atrial fibrillatory rate was obtained by QRST cancellation and time frequency analysis of electrocardiogram at admission. The study population comprised 148 patients (age 64 ± 13 years, 52 men), of whom 48 converted to SR within 18 h. Those converting spontaneously comprised more women, had a higher prevalence of first-ever AF episode, IHD, and a lower AFR. The multivariate analysis revealed: AFR < 350 fibrillations per minute [odds ratio (OR) 3.7, 95% confidence interval (CI) 1.3-10.5, P = 0.016], IHD (OR 5.7, 95% CI 1.5-22.4, P = 0.012) and first-ever AF episode (OR 4.1, 95% CI 1.3-13.0, P = 0.015) as independent predictors of spontaneous conversion.
A low AFR was predictive of spontaneous conversion in patients with recent-onset AF. Along with first-ever AF episode and IHD, AFR can be used in assessing likelihood of spontaneous conversion, if proven in prospective studies.
心房颤动频率（AFR）被认为是心房重构的非侵入性指标。低 AFR 与持续性心房颤动（AF）患者干预后的良好结果相关。然而，在 AF 持续时间较短、容易自发恢复窦性心律（SR）的未经选择的患者中，从未研究过 AFR。本研究旨在评估 AFR 是否可以预测新发 AF 患者的自发转复。
在 12 个月期间筛选了因 AF < 48 h 而寻求急诊治疗的连续患者的文件（n = 225）。排除了甲状腺疾病、急性缺血性心脏病（IHD）或急性充血性心力衰竭、严重瓣膜性心脏病、先天性心脏病、心脏手术或导管消融史或 I 类/III 类抗心律失常药物的患者。在入院时通过 QRST 取消和心电图的时频分析获得心房颤动频率。研究人群包括 148 名患者（年龄 64 ± 13 岁，52 名男性），其中 48 名在 18 小时内自发转为 SR。那些自发转复的患者中，女性更多，首发 AF 发作、IHD 的发生率更高，AFR 更低。多变量分析显示：AFR < 350 次/分钟[优势比（OR）3.7，95%置信区间（CI）1.3-10.5，P = 0.016]、IHD（OR 5.7，95% CI 1.5-22.4，P = 0.012）和首发 AF 发作（OR 4.1，95% CI 1.3-13.0，P = 0.015）是自发转复的独立预测因素。
在新发 AF 患者中，低 AFR 可预测自发转复。如果在前瞻性研究中得到证实，AFR 可与首发 AF 发作和 IHD 一起用于评估自发转复的可能性。
