心房颤动导管消融术后心率的变化Changes in heart rate after catheter ablation of atrial fibrillation
孙育民,刘旭,王新华,施海峰,顾佳宁,周立,胡伟,李若谷,方唯一
摘要(Abstract)：
目的评价心房颤动(房颤)导管消融术后心率变化的时间效应。方法入选导管消融术后随访无房性心动过速或房颤复发的症状性房颤患者52例,平均年龄64.65±10.18岁(38～76岁)。于术前、术后1周、1个月、3个月、6个月、12个月随访24小时动态心电图,观察平均心率的变化。结果52例均完成导管消融术,术前平均心室率为68.92±7.53次/min,术后1周、1个月和3个月的平均心室率分别为75.58±6.48次/min、71.13±6.45次/min和68.90±7.28次/min。43例随访6个月时的心室率为70.47±5.95次/min。22例随访12个月时的心室率为69.95±5.35次/min。除术后1周平均心率与术前相比差异有统计学意义(P<0.05)外,余均无明显变化。结论房颤消融可引起心率增加,以术后1周最为明显。症状明显者可增服控制心率的药物。
关键词(KeyWords)： 心房颤动;导管消融术;肺静脉;心率
基金项目(Foundation):
作者(Author): 孙育民,刘旭,王新华,施海峰,顾佳宁,周立,胡伟,李若谷,方唯一
参考文献(References)：
- [1]Khaykin Y,Marrouche NF,Martin DO,et al.Pulmonary vein i-solation for atrial fibrillation in patients with symptomatic sinus bradycardia or pauses.J Cardiovasc Electrophysiol,2004,15:784-789.
- [2]Hocini M,Sanders P,Deisenhofer I,et al.Reverse Remodeling of Sinus Node Function After Catheter Ablation of Atrial Fibrilla-tion in Patients With Prolonged Sinus Pauses.Circulation,2003,108:1172-1175.
- [3]王新华,刘旭,顾佳宁,等.环肺静脉消融电隔离治疗持续性心房颤动的疗效观察.中国介入心脏病学杂志,2006,14:147-151.
- [4]Friedman PL,Stevenson WG,Kocovic DZ.Autonomic dysfunc-tion after catheter ablation.J Cardiovasc Electrophysiol,1996,7:450-459.
- [5]Geller C,Goette A,Carlson MD,et al.An increase in sinus rate following radiofrequency energy application in the posteroseptal space.Pacing Clin Electrophysiol,1998,21:303-307.
- [6]Kocovic DZ,Harada T,Shea JB,et al.Alterations of heart rate and of heart rate variability after radiofrequency catheter ablation of supraventricular tachycardia.Delineation of parasympathetic pathways in the human heart.Circulation,1993,88:1671-1681.
- [7]Hsieh MH,Chiou CW,Wen ZC,et al.Alterations of heart rate variability after radiofrequency catheter ablation of focal atrial fi-brillation originating from pulmonary veins.Circulation,1999,100:2237-2243.
- [8]Nilsson B,Chen X,Pehrson S,et al.Increased resting heart rate following radiofrequency catheter ablation for atrial fibrillation.Europace,2005,7:415-420.
- [9]Pappone C,Santinelli V,Manguso F,et al.Pulmonary vein denervation enhances long-term benefit after circumferential abla-tion for paroxysmal atrial fibrillation.Circulation,2004,109:327-334.
- [10]Ouyang F,Bansch D,Ernst S,et al.Complete Isolation of Left Atrium Surrounding the Pulmonary Veins:NewInsights From the Double-Lasso Technique in Paroxysmal Atrial Fibrillation.Circu-lation,2004,110:2090-2096.