右侧房室旁路导管射频消融术对心率变异性的影响

Influence of Radiofrequency Current Catheter Ablation of Right-Sided Accessory Pathway on Heart Rate Variability

目的：针对右侧旁路导管射频消融术较为困难，放电次数较多，射频电流能量较大的特点，对１５例右侧房室旁路患者进行导管射频消融术前后的心率变异性分析，旨在了解右侧旁路导管射频消融术对心脏自主神经功能的影响。方法：所有患者均于术前及术后第１天大致同一时间、同一安静环境下采取５分钟的心脏搏动，并排除药物及其它影响心率变异性的因素，经短时心率变异性分析软件，得到心率变异性的时域及频域指标，采用配对ｔ检验进行统计学分析。结果：最小心率及平均心率升高，ＲＲ间期均值的标准差、ＲＲ间期差值的均方根、ＲＲ间期差值大于５０ｍｓ的百分比及高频能谱降低，且有统计学意义（Ｐ＜０．０５）。结论：右侧旁路导管射频消融术在阻断异常传导的同时，亦导致以副交感神经功能损伤为主的心率变异性的降低。

Objective: As more delivervies and higher energy of radiofrequency current should be used in the ablation of right-sided accessory pathway, heart rate variability was analyzed in 15 patients with right-sided accessory pathway before and after ablation in order to observe the influence of radiofrequency current catheter ablation on the function of autonomic nervous system. Methods: Five-minute electrocardiographic tracing was obtained before and after ablation at similar situations, the parameters of time-domain and frequency-domain were measured by computer,al1 the parameters were compared using paired Student's t-test and chi-square analysis. Results:The minimum heart rate and mean heart rate after ablation were higher than those before ablation, while the standard deviation of average RR intervals, the root mean square of successive difference of RR intervals, the percentage of differences between consecutive normal RR intervals>50 ms and the high frequency energy spectrum after ablation were lower than those before ablation (all p<0.05).Conclusion: Radiofrequency current catheter ablation could cause decrease of heart rate variability dueto damage of the cardiac autonomic nerve function, especially of the parasympathetic nerve.