P波离散度与阵发性房颤经导管射频消融术后复发的关系

P Wave Dispersion:a Predictor of Atrial Fibrillation Recurrence after Catheter Ablation

目的:探讨P波离散度与阵发性房颤经导管射频消融术后房颤复发的关系。方法:78例初次行导管射频消融治疗的阵发性房颤患者,消融术式为电解剖标测系统加单环状标测电极指导下的环肺静脉线性消融术。测量术前体表心电图各导联的P波时限,计算P波离散度。结果:术后随访32.9±4.8个月,有效组64例,复发组14例。复发组术前的P波离散度(46.2±11.8ms)较有效组(37.4±14.2ms)大(P<0.05)。若以40ms为界值,术前P波离散度预测术后房颤复发的敏感性为86%,特异性为59%。其他的临床及心电图指标在两组间无显著差异。结论:经导管射频消融治疗阵发性房颤的疗效肯定,复发组患者术前的P波离散度明显大于非复发组,术前P波离散度对术后房颤的复发有一定预测价值。

Objective： To investigate whether 12-1eadele EKG parameters predict atrial fibrillation （AF） recurrence after catheter ablation. Methods： Under the guidance of electroanatomic mapping system, 78 patients with paroxysmal atrial fibrillation （PAF） underwent circumferential isolation of ipsilateral pulmonary veins. P wave durations were measured. Results： At 32.9 ± 4.8 months of follow-up, 45 patients were free from atrial arrhythmia without antiarrhythmic drugs （AADs）, 19 patients had a more than 90~/00 reduction in AF burden with the use of AADs. These 64 patients were referred to efficacious group. The remaining 14 patients suffering from AF or new onset atrial tachyeardia/flutter after the procedure constituted recurrent group. Patients in the recurrent group had an increased pre-procedure P wave dispersion, compared with the efficacious group（46.2±11. 8ms vs. 37.4±14.2ms, P〈0.05）. With a cut off value of 40ms, the sensitivity and specificity of pre-proeedure P wave dispersion in predicting post procedure AF recurrence were 85 %0 and 59%, respectively. Conelusion： Catheter ablation has substantial efficacy in the treatment of PAF, the pre-procedure P wave dispersion may predict AF recurrence after PAF ablation.