Xu Zhen-Xing, Zhong Jing-Quan, Zhang Wei, Yue Xin, Rong Bing, Zhu Qing, Zheng Zhaotong, Zhang Yun
Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Department of Cardiology, Qilu Hospital of Shandong University, China.
Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Department of Cardiology, Qilu Hospital of Shandong University, China.
Ultrasound Med Biol. 2014 Jun;40(6):1133-7. doi: 10.1016/j.ultrasmedbio.2014.01.006. Epub 2014 Mar 6.
This study aimed to assess whether intra- and inter-atrial conduction delay could predict atrial fibrillation (AF) for paroxysmal supraventricular tachycardia (PSVT) patients after successful treatment by radiofrequency catheter ablation (RFCA). Echocardiography examination was performed on 524 consecutive PSVT patients (15 patients were excluded). Left atrial dimension, right atrial diameter and intra- and inter-atrial conduction delay were measured before ablation. Patients were divided into group A (n = 32): occurrence of AF after the ablation and group B (n = 477): remained in sinus rhythm during follow-up. Receiver operating characteristic (ROC) curve analysis was performed to estimate the predictive value of intra- and inter-atrial conduction delay. Both intra- and inter-atrial conduction delay were higher in group A than in group B (4.79 ± 0.30 msec vs. 4.56 ± 0.32 msec; 21.98 ± 1.32 msec vs. 20.01 ± 1.33; p < 0.05). Binary logistic regression analysis showed that intra- and inter-atrial conduction were significant influential factors for the occurrence of AF (odds ratio [OR] = 13.577, 95% confidence interval [CI], 3.469-48.914; OR = 2.569, 95% CI, 1.909-3.459, p < 0.05). The ROC cure analysis revealed that intra-atrial conduction delay ≥ 4.45 msec and inter-atrial conduction delay ≥ 20.65 were the most optimal cut-off value for predicting AF in PSVT patients after RFCA. In conclusion, this is the first study to show that the intra- and inter-atrial conduction delay could effectively predict AF in post-ablation PSVT patients.
本研究旨在评估对于阵发性室上性心动过速（PSVT）患者，在经射频导管消融（RFCA）成功治疗后，心房内和心房间传导延迟是否能够预测房颤（AF）。对524例连续的PSVT患者进行了超声心动图检查（排除15例患者）。在消融前测量左心房内径、右心房直径以及心房内和心房间传导延迟。患者被分为A组（n = 32）：消融后发生房颤；B组（n = 477）：随访期间维持窦性心律。采用受试者工作特征（ROC）曲线分析来评估心房内和心房间传导延迟的预测价值。A组的心房内和心房间传导延迟均高于B组（4.79±0.30毫秒对4.56±0.32毫秒；21.98±1.32毫秒对20.01±1.33毫秒；p<0.05）。二元逻辑回归分析显示，心房内和心房间传导是房颤发生的显著影响因素（比值比[OR]=13.577，95%置信区间[CI]，3.469 - 48.914；OR = 2.569，95% CI，1.909 - 3.459，p<0.05）。ROC曲线分析显示，心房内传导延迟≥4.45毫秒和心房间传导延迟≥20.65毫秒是预测RFCA术后PSVT患者房颤的最适宜截断值。总之，这是第一项表明心房内和心房间传导延迟能够有效预测消融后PSVT患者房颤的研究。
