摘要
目的探讨老年原发性高血压患者阵发性心房颤动(PAf)的心电启动机制。方法选择老年原发性高血压伴PAf患者63例(高血压组),进行动态心电图人工回放,分析PAf心电触发因素、PAf发作前120、60和30 s房性期前收缩(APB)发作频率及其起源部位,另选老年非高血压PAf患者44例(非高血压组)进行比较。结果高血压组心电触发因素主要为APB(66.2%),触发PAf的APB主要来源于左心房上部(61.7%)。高血压组PAf前120、60和30 s APB发作频率明显高于非高血压组(P<0.01)。高血压组触发性APB联律间期和期前收缩指数均明显低于非高血压组,而期前收缩前心动周期明显高于非高血压组(P<0.01)。结论与老年非高血压PAf患者相似,APB特别是起源于左心房上部是老年原发性高血压患者PAf最主要的触发因素。
Objective To explore the electrophysiological initiating mechanism of paroxysmal atrial fibrillation（PAf） in elderly patients with essential hypertension and its clinical significance. Methods Artificial playback of ambulatory electrocardiogram was performed for 63 cases of essential hypertension aged over 60 years with PAf（hypertension group） and 44 elderly patients with non- hypertensive PAl（non-hypertension group）, to analyze the electrophysiological initiating factors of PAf and the frequency of atrial premature beats（APB） within 120,60 and 30 seconds before PAf onset,and to identify the originating site of APB initiating PAf. Results The main factor that initiated PAf was APB which accounted for 66. 2% and predominantly originated in upper left atrium（accounted for 61.7%）. The frequencies of APB during 120,60 and 30 seconds just before PAf onset in hypertensive PAf patients were all significantly higher than those in non-hypertensive PAf patients（P〈0.01）. Both coupling interval and prematurity indices of triggering APB in hypertensive group were significantly lower than those in non-hypertensive group（P〈0.01）, while the pre-APB cardiac cycle in hypertensive group was significantly higher than that in non- hypertensive group （ P〈 0.01 ）. Conclusions Similar to non-hypertensive PAf, APB, especially that originated in upper left atrium is the main initiating factor of PAf in elderly patients with hypertensive PAfs.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2012年第1期29-31,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
高血压
心房颤动
心电描记术
便携式
心房早搏复合征
hypertension
atrial fibrillation
electrocardiography, ambulatory
atrial premature complexes
