Zhao Q-X, Zhao Y-M, Mao L, Shen D-L, Zhao X-Y
Department of Cardiology, Zhengzhou People's Hospital, Zhengzhou, China.
Eur Rev Med Pharmacol Sci. 2017 Feb;21(3):584-589.
Paroxysmal supraventricular tachycardia (PSVT) patient has higher prevalence ratio of atrial fibrillation (AF), while AF recurrence remains a high ratio after radiofrequency ablation (RFCA). This study explored AF prevalence and atrial vulnerability in PSVT patients after RFCA, using ROC curve to analyze atrial effective refractory period dispersion (dERP) on postoperative AF in the prediction of PSVT.
The PSVT patients were enrolled and divided into three groups and received RFCA treatment between January 2010 and December 2014. Group A, AF was induced by programmed electrical stimulation (PES) under isopropyl epinephrine (ISO) perfusion; group B, AF was induced by PES or PES under ISO perfusion; group C, no AF was generated by PES or PES under ISO perfusion. Ultrasonic cardiogram was applied to detect intra, inter, atrial electromechanical delay and dERP. ROC curve was adopted to analyze the prediction effect of dERP on postoperative AF recurrence.
dERP, group B > A > C; inter and intra: group B > A (p<0.05). Logistic regression analysis showed that age, gender, sympathetic nerve stimulation, and left/right atrial diameter were independent risk factors of postoperative AF in PSVT patients (p<0.05). Of note, dERP cut-off value at 75.5 msec can effectively predict AF recurrence in PSVT patients after RFCA (p<0.05).
Atrial vulnerability index dERP could be applied to evaluate AF recurrence in PSVT patients after RFCA.
阵发性室上性心动过速（PSVT）患者心房颤动（AF）的患病率较高，而射频消融（RFCA）后AF复发率仍然很高。本研究探讨了RFCA术后PSVT患者的AF患病率和心房易损性，使用ROC曲线分析心房有效不应期离散度（dERP）对PSVT术后AF的预测价值。
纳入2010年1月至2014年12月期间接受RFCA治疗的PSVT患者并分为三组。A组，在异丙肾上腺素（ISO）灌注下通过程控电刺激（PES）诱发AF；B组，通过PES或在ISO灌注下的PES诱发AF；C组，通过PES或在ISO灌注下的PES未诱发AF。应用超声心动图检测心房内、心房间、心房机电延迟和dERP。采用ROC曲线分析dERP对术后AF复发的预测效果。
dERP，B组>A组>C组；心房间和心房内：B组>A组（p<0.05）。Logistic回归分析显示，年龄、性别、交感神经刺激和左/右心房直径是PSVT患者术后AF的独立危险因素（p<0.05）。值得注意的是，dERP临界值为75.5毫秒可有效预测RFCA术后PSVT患者的AF复发（p<0.05）。
心房易损性指数dERP可用于评估RFCA术后PSVT患者的AF复发情况。
