自发转复阵发性心房颤动100例P波离散度分析

P wave dispersion in patients with self-cardioversioned paroxysmal atrial fibrillation

目的探讨P波离散度(P wave dispersion,PD)预测伴器质性心脏病的阵发性心房颤动。方法自发转复阵发性心房颤动100例分为3组,孤立性心房颤动组:无器质性心脏病,年龄在60岁或以上42例。器质性心房颤动组:阵发性心房颤动伴器质性心脏病,58例,其中年龄小于60岁(包括60岁)20例,年龄超过60岁38例。对照组80例,无器质性心脏病及阵发性心房颤动,其中,年龄小于60岁(包括60岁)43例,年龄超过60岁37例。用SR-1000C型心电综合分析仪同步测量12导联心电图P波最大波宽(Pmax)、P波最小波宽度(Pmin)和PD。结果Pmax和Pmin在孤立性心房颤动组、器质性心房颤动组与对照组的年龄比较,差异无统计学意义(P>0.05),然而Pmax与PD在器质性心房颤动组与对照组之间差异有统计学意义(P<0.05)。结论PD可预测孤立性心房颤动和器质性阵发性心房颤动的无创而可靠指标。

Objectives To investigate the predictive value of P wave dispersion as a marker for selfcardioversioned paroxysmal atrial fibrillation （PAF） in patient with organic heart diseases. Methods One hundred subjects with PAF were divided into three groups： group Ⅰ , 42 subjects with paroxysmal lone atrial fibrillation aged equal or below 60 years （without organic heart diseases） ; group Ⅱ , 58 paroxysmal atrial fibrillation patients with organic heart disease, were categorized into two subgroups according to their age ： group Ⅱ a, 20 subjects aged equal or below 60 years, group Ⅱ b： 38 patients aged above 60 years. 80 healthy subjects without paroxysmal atrial fibrillation and organic heart diseases served as control group, categorized into two subgroups according to their age： control group Ⅰ ： 43 healthy subjects aged equal or below 60 years; control group Ⅱ： 37 healthy subjects aged above 60 years. P wave maximum width （Pmax） and P wave minimum width （Pmin） were measured in a 12-lead ECG with SR-1000C ECG analyzer. P wave dispersion was the difference between Pmax and Pmin （PD= Pmax- Pmin）. Data were analysed by the SPSS 8.0 software, using oneway ANOVA method. Results For group Ⅰ （paroxysmal lone atrial fibrillation） , group Ⅱ （paroxysmal atrial fibrillation patients with organic heart disease, regardless of age）, control group Ⅰ and control group Ⅱ , results showed that no significant differences （P 〉 0.05） were existed in both PD and Pmax, among subjects in the same kind of groups. Meanwhile data suggested that there was significant difference （P〈 0.05） in both PD and Pmax between PAF subjects （including group Ⅰ, group Ⅱ a and group Ⅱ b） and healthy subjects （including control group I and control group Ⅱ ）. Conclusions P wave dispersion, as a non-invasive and reliable new marker, can predict both paroxysmal lone atrial fibrillation and paroxysmal atrial fibrillation in patients with organic heart disease.