胺碘酮转复持续性心房颤动对房颤波主导心房周长的影响

Effect of cardioversion of persistent atrial fibrillation with amiodarone on dominant atrial cycle length

目的：探讨心房颤动（简称房颤）波的主导心房周长（Dominant atrial cycle length，DACL）在房颤药物复律过程中的变化和可能的机制。方法：对30例持续性房颤服用胺碘酮的患者，于服药前、后的1～14d进行房颤波的采样分析，并计算DACL、P2／P．（第二频峰的功率与第一频峰功率的比值）比值。结果：服药14d后有21例转复成窦性心律（A组），9例未能转复（B组）。所有患者服药后的DACL和P2／P，较服药前明显延长和变小（246±27）msvs（150±31）ms，（215±22）msVS（143±28）ms，（0．32±0．24）vs（0．43±0．21），（0．49±0．28）VS（0．53±0．23），P〈0．05-P〈0．001），复律组复律前的DACL较未复律组的DACL延长更为明显（246±27）ms vs （215±22）ms P〈0．001）。结论：DACL是判断房颤复律成功与否的有用指标。

Objective： To explore the change of dominant atrial cycle length （DACL） for atrial fibrillation waves during the procedure of pharmaceutical defibrillation for persistent atrial fibrillation（AF）. Methods： The AF waves had been sampled for thirty patients with persistent AF before and after oral amiodarone loading for 14 days. DACL and the ratio of the power of second peak to power of first peak （ P2/P1 ） for each patient were calculated from frequency spectrum. Results： After 14 days, twenty-one patients restored to sinus rhythm among the thirty patients and the rest 9 patients were still in persistent AF. All patients＇ DACL was prolonged, but the ratio of P2/P1 was decreased. DACL of 21 patients who restored to sinus rhythm before cardioversion had prolonged more obviously than patients who were under atrial fibrillation. Conclusion： DACL is a useful parameter in judging whether atrial fibrillation has been relieved or not.