射频消融术后心率变异性的初步探讨

The Initial Study of Heart Rate Variability After Radiofrequency Ablation

采用５ｍｉｎ功率谱分析法，并辅以时域指标，比较射频消融术前、后患者的心率变异性，以评价心脏自主神经功能状况的改变。结果表明，心率变异性的功率谱呈三个明显峰，即０．０４Ｈｚ以下的超低频峰，０．０４～０．１５Ｈｚ的低频峰，０．１５～０．３５Ｈｚ的高频峰；射频消融术后平均心率由７４．２±９．４ｂｐｍ上升至８１．３±１４．０ｂｐｍ（Ｐ＞０．０５）；平均心率的标准差及高频成分明显降低，分别由３．７０±１．４５ｂｐｍ降至２．８５±０．７５ｂｐｍ（Ｐ＜０．０５）和３８０．２±２．３ｂｐｍ２降至１５１．４±３．４ｂｐｍ２（Ｐ＜０．０１）．本结果提示：射频消融术在切断异常传导路径的同时，亦影响了心脏的自主神经，尤其是迷走神经，其机制尚不清楚。

Five minute spectral analysis,along with time-domain index were used to compare the heart rate variability of patients before and after radiofrequency ablation in order to assess the functional changes of cardiac autonomic nervous system.The results displayed that three distinct peaks appeared in the power spectrum of heart rate variability,They were ultralow-frequency peak below 0.04 Hz,low-frequency peak from 0.04 to 0.15 Hz,and hish-frequency peak from 0.15 to 0.35 Hz,The average heart rate after ablation went up from 74.2±9.4 bpm to 81.3±14.0bpm(P>0.05).The standard deviation of average heart rate and the highfrequency component reduced evidently,i.e.from 3.70±1.45 bpm to 2.85±0.75 bpm(P<0.05)and 380.2±2.3 bpm2 to 151.4±3.4 bpm2(P<0.01)repectively.The results indicate that while radio-frequency ablation cuts off the abnormal conduction routes,it also exerts effects on cardiac autononomic nerves,esp.the parasympahtetic nerves.The machanisms are still not known.