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低心率减速能力意味着消融后无房颤发生率更高。

Low heart deceleration capacity imply higher atrial fibrillation-free rate after ablation.

机构信息

Departmentof Cardiology, the First Affiliated Hospital of Soochow University, 296 Shizi Street, Suzhou, 215006, China.

Departmentof Electrocardiography, the First Affiliated Hospital of Soochow University, 296 Shizi Street, Suzhou, 215006, China.

出版信息

Sci Rep. 2018 Apr 3;8(1):5537. doi: 10.1038/s41598-018-23970-7.

Abstract

How deceleration capacity (DC) and acceleration capacity (AC) of heart rate associated with atrial fibrillation (AF) and ablation is still not clear. The dynamic changes of AC, DC and conventional heart rate variability (HRV) parameters were characterized in 154 subjects before circumferential pulmonary veins isolation (CPVI) and three days, 3 months and 6 months after CPVI. The DCs of the recurrent group decreased significantly at each time point after CPVI; the DCs of the recurrence-free group before CPVI and three days, 3 months and 6 months after CPVI were 7.06 ± 1.77, 3.79 ± 1.18, 4.22 ± 1.96 and 3.97 ± 0.98 ms respectively, which also decreased significantly at each time point and were significantly lower than these of recurrent group. Conversely, the AC of recurrent and recurrence-free groups increased significantly at each time point after CPVI; the ACs of recurrence-fee group were significantly higher than these of recurrent group at each time point. No stable difference trend of HRV parameters was found between two groups. Further Kaplan-Meier analysis showed that DC < 4.8 ms or AC ≥ -5.1 ms displayed significant higher recurrence-free rates. In conclusion, high AC and low DC imply higher AF-free rate after ablation.

摘要

心率减速能力(DC)和加速能力(AC)与心房颤动(AF)和消融的关系尚不清楚。本研究旨在描述 154 例患者在环肺静脉隔离(CPVI)前后 3 天、3 个月和 6 个月的 AC、DC 和常规心率变异性(HRV)参数的动态变化。CPVI 后,复发组的 DC 在各个时间点均显著降低;CPVI 前、CPVI 后 3 天、3 个月和 6 个月的无复发组 DC 分别为 7.06±1.77、3.79±1.18、4.22±1.96 和 3.97±0.98ms,也在各个时间点显著降低,且显著低于复发组。相反,复发组和无复发组的 AC 在 CPVI 后各个时间点均显著升高;无复发组的 AC 在各个时间点均显著高于复发组。两组间 HRV 参数无稳定的差异趋势。进一步的 Kaplan-Meier 分析表明,DC<4.8ms 或 AC≥-5.1ms 显示出更高的无复发生存率。结论:消融后高 AC 和低 DC 提示更高的 AF 无复发生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1fa/5883009/23c4c9d048ff/41598_2018_23970_Fig1_HTML.jpg

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