触发心房颤动的房性期前收缩特征及抗心房颤动起搏器的疗效

Characteristic of atrial premature triggering atrial fibrillation and the effect of anti-atrial-fibrillation pacemaker

目的:探讨触发阵发性心房颤动(AF)的房性期前收缩(AP)心电图特征,并观察抗AF起搏程序对其的影响。方法:对24例置入抗AF起搏器的患者,通过24h动态心电图分析阵发性AF的触发情况,比较诱发AF与未诱发AF的AP的联律间期、AP代偿间期和AP或AF前2min内的AP频率,并观察AP后反应程序对AF的预防作用。结果:诱发AF的AP比未诱发AF的AP显著提前[(352.3±30.4)ms∶(421.8±42.5)ms,P<0.05],诱发AF的AP代偿间期长[(963±109)ms∶(733±124)ms,P<0.05],AP或AF前2min内的AP频率快[(21.7±15.3)次/min∶(12.7±8.7)次/min,P<0.05];7例AP后间歇触发的AF超速起搏有效,17例启动AP响应程序后AF发作停止或减轻。结论:AP是否触发阵发性AF不仅与AP的联律间期有关,而且与AP代偿间期及AP或AF前2min内的AP频率有关;抗AF起搏器能有效地防治AP等触发因素诱发的阵发性AF。

Objective：To investigate the characteristic of atrial premature （AP） which triggers paroxysmal atrial fibrillation （AF）, and to observe the effect of anti-atrial-fibrillation programing on them. Method： The holter monitoring data in24 patients implanted with anti-atrial-fibrillation were analysed. The coupling interval, compensating interval of AP triggering AF and AP without triggtring AF. and the frequency of AP in 2 minutes before AF were detected. Result： AP triggering AF happened earlier than AP not without AF （[-352.3 ±30.4] ms ： [-421.8±42.5] ms,P〈0.05）, Compensating interval in AP triggering AF was longer than that of the latter （[-963±109] ms ： [733±124] ms,P〈0.05）, AF supur-accelerating pacing triggered by anteceding AP was effective in 7 patients. AF was ended or lessened after the iniation of ＂post PAC response program＂ in 17 patients. Conclusion：Whether AP triggers AF is related to the coupling interval, compensating interval, and the AP frequency in the 2 minutes ahead of AP or AF; Anti-fibrillation pacemaker can effectivelly treat the paroxysmal AF triggered by AP.