居维竹,陈明龙,杨兵,徐东杰,陈红武,陈椿,单其俊,邹建刚,曹克将

• 1:南京医科大学第一附属医院心脏科

摘要(Abstract)：

目的观察环肺静脉左房线性消融术对窦性心率震荡(HRT)的影响,了解消融术对心脏迷走神经即刻活动的影响。方法2006年3月至2006年12月间行射频消融术的阵发性心房颤动(AF)患者44名(男性26例,女性18例),年龄24~76(53±11)岁,左房内径27~50(36±5)mm,射血分数65%±4%(49%~71%)。消融前及消融后即刻行右室心尖部RS2期前刺激,偶联间期60%,电压2倍于舒张期阈值,并以5次期前收缩的平均值为基础,测量术前、术后震荡初始TO(tur-bulence onset)及震荡斜率TS(turbulence slope)。对照组为同期行室上性心动过速射频消融的患者37名(男性20例,女性17例),左房内径34±3 mm,射血分数65%±3%。结果AF组和对照组HRT差异无统计学意义:TO为-0.021 6%±0.023 6%比-0.023 6%±0.018 5%(P=0.67),TS为7.331 8±6.983 5 ms/RR比9.667 9±6.065 2 ms/RR(P=0.12)。AF组射频消融前HRT与射频消融后比较,其中TO为-0.021 6%±0.023 6%比0.000 9%±0.013 3%(P<0.01),TS为7.331 8±6.983 5 ms/RR比2.055 3±2.172 4 ms/RR(P<0.01),差异有统计学意义。结论HRT的变化趋势表明环肺静脉左房线性消融术中发生去迷走效应是普遍的现象,而并非一定表现为生命体征的改变。这种变化本身也提示射频能量引起迷走反射主要为损伤或者刺激了迷走传入支而非传出支。

关键词(KeyWords)： 心房颤动;导管消融术;心率

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 居维竹,陈明龙,杨兵,徐东杰,陈红武,陈椿,单其俊,邹建刚,曹克将

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