摘要
目的探讨消融旁道后心房颤动(房颤)复发的预激综合征患者24 h动态心电图最大P波时限(Pmax)、P波离散度(Pd),并分析其对房颤复发的预测效能及临床意义。方法选取2019年5月~2022年5月北京中医医院顺义医院52例消融旁道后房颤复发的预激综合征患者为研究组,另选同期52例消融旁道后无房颤复发的预激综合征患者为对照组。比较两组临床资料、消融前后24 h动态心电图P波参数(Pmax、Pd)及变化值(△Pmax、△Pd)。Lasso-logistic回归模型分析房颤复发的相关因素。分析消融前、消融后2 d P波参数及变化值对房颤复发的预测价值。结果研究组年龄、病程、左心房内径、消融前房颤发作频率、消融前Pmax、Pd及消融后2 d Pmax、Pd均高于对照组[(50.26±8.13)岁比(41.31±7.65)岁、(5.29±1.18)年比(4.06±0.95)年、(42.39±4.12)mm比(32.68±3.97)mm、(5.79±1.26)次/月比(3.82±1.04)次/月、(121.57±11.68)ms比(104.95±10.24)ms、(55.36±8.73)ms比(41.70±7.21)ms、(112.39±10.75)ms比(92.44±9.30)ms、(50.18±7.69)ms比(34.07±6.42)ms],研究组LVEF、△Pmax、△Pd均低于对照组[(56.27±10.35)%比(65.14±11.42)%、(9.18±1.69)ms比(12.51±1.81)ms、(5.18±1.22)ms比(7.63±1.43)ms,P<0.05]。年龄、LVEF、消融前房颤发作频率、消融前后Pmax、Pd、△Pmax、△Pd为房颤复发的影响因素(P<0.05);△Pmax、△Pd联合预测房颤复发的AUC为0.931,大于消融前后Pmax、Pd联合预测的AUC 0.853、0.876(P<0.05);基于影响因素构建预测模型,含P波参数变化值预测房颤复发的AUC为0.952,大于不含P波参数变化值预测的AUC 0.875(P<0.05)。结论24 h动态心电图Pmax、Pd变化值对预激综合征患者消融旁道后房颤复发具有一定预测价值。
Objective To investigate the maximum P wave duration(Pmax)and P wave dispersion(Pd)of 24 h dynamic electrocardiogram in patients with preexcitation syndrome with atrial fibrillation recurrence after bypass ablation,and their predictive efficacy and clinical significance for atrial fibrillation recurrence.Methods A total of 52 patients with pre-excitation syndrome who had undergone atrial fibrillation recurrence after ablation of accessory pathways admitted to the Beijing Hospital of Traditional Chinese Medicine Shunyi Hospital from May 2019 to May 2022 were selected as the study group,and another 52 patients with pre-excitation syndrome who had no atrial fibrillation recurrence after ablation of accessory pathways were selected as the control group.The clinical data,P wave parameters(Pmax,Pd)and changes(△Pmax,△Pd)of 24 h before and after ablation were compared between the two groups.Lasso-logistic regression model was used to analyze the related factors of atrial fibrillation recurrence.The predictive value of P wave parameters and their changes before and 2 days after ablation for the recurrence of atrial fibrillation were analyzed.Results The age,duration of disease,left atrial diameter,pre-ablation atrial fibrillation frequency,preablation Pmax and Pd and 2 day postablation Pmax and Pd of the study group were higher than those in the control group[(50.26±8.13)years vs.(41.31±7.65)years,(5.29±1.18)years vs.(4.06±0.95)years,(42.39±4.12)mm vs.(32.68±3.97)mm,(5.79±1.26)times/month vs.(3.82±1.04)times/month,(121.57±11.68)ms vs.(104.95±10.24)ms,(55.36±8.73)ms vs.(41.70±7.21)ms,(112.39±10.75)ms vs.(92.44±9.30)ms,(50.18±7.69)ms vs.(34.07±6.42)ms];the LVEF,△Pmax,and△Pd in the study group were lower than those in the control group[(56.27±10.35)%vs.(65.14±11.42)%,(9.18±1.69)ms vs.(12.51±1.81)ms,(5.18±1.22)ms vs.(7.63±1.43)ms,P<0.05].Age,LVEF,pre-ablation atrial fibrillation attack frequency,preablation and postablation Pmax and Pd as well as△Pmax and△Pd were the influencing factors of at
作者
马跃新
王巍
MA Yue-xin;WANG Wei(Department of cardiology,Functional testing department,Beijing Hospital of Traditional Chinese Medicine Shunyi Hospital,Beijing 101300,China)
出处
《中国心血管病研究》
CAS
2023年第11期1020-1026,共7页
Chinese Journal of Cardiovascular Research
关键词
预激综合征
射频消融术
心房颤动
最大P波时限
P波离散度
复发
动态心电图
预测
Preexcitation syndrome
Radio frequency ablation
Atrial fibrillation
Maximum p-wave duration
P-wave dispersion
Relapse
Dynamic electrocardiogram
Forecast
