自限发作性房颤对房颤电复律后复发的预测

Self - limited episodes of atrial fibrillation after direct current cardioversion predict recurrence of persistent atrial fibrillation

目的通过观察自限发作性房颤来评价对房颤电复律后复发的预测。方法80例持续性房颤病人，成功接受直流电复律后1周、3周和6周监测24h动态心电图。结果80例病人中73例恢复窦性心律，随访6周，40例（54％）维持窦性心律，33例（24％）转为持续性房颤。第1周Holter记录有自限发作性房颤的病人为8例（24％）；在40例未复发的病人中，第1周Holter记录有自限发作性房颤芡生的病人为12例（30％），两者相比差异无统计学意义（P〉0．05）。Holter在第一、二和三次记录中，分别有21例（41％）、22例（51％）和15例（38％）发生自限发作性房颤。结论在房颤电复律后6周内，自限发作性房颤不能预测持续性房颤的发生，并且窦性心律伴短阵自限发作性房颤的发生在复律病人后很常见。

Objective To evaluate if self- limited episodes of atrial fibrillation after direct current（DC） cardioversion predict recurrence of persistent atrial fibrillation. Methods Consecutive patients with persistent atrial fibrillation, scheduled for DC cardioversion were prospectively included in the study. Ambulatory ECG Holter monitoring （24 h） was performed one, three and 6 weeks after successful cardioversion. Results A total of 80 patients were prospectively included in the study. Sinus rhythm was restored in 73 patients （88%）. At 6 weeks of follow -up 40 patients out of 73 （.54%） had sinus rhythm, and 33 patients （46%） had relapsed into persistent atrial fibrillation. Eight out of these 34 patients （24%） had bursts of atrial fibrillation at their filet Holter recording, compared to 12 patients out of 40 （30%） in sinus rhythm at 6 weeks （ P 〉0.05）. On the first, second and third Holter recording 21 patients out of 51 （41%）, 22 patients out of 43 （51%） and 15 out of 40 patients （38%） had self-limited bursts of atrial fibrillation,respeetively. Conclusion In patients successfully converted to sinus rhythm self- limited bursts of atrial fibrillation do not predict recurrence of persistent atrial fibrillation during 6 weeks of follow up. Brief self - limited episodes of atrial fibrillation are common, and the incidence and duration of such episodes are constant during a 6 weeks period after DC cardioversion.