彩色多普勒超声心动图对房颤病人复律后左房收缩功能的观察

Doppler Color Echocardiographic Observation of Left Atrial Systolic Function Following Conversion of Atrial Fibrillation in Patients

目的：对房颤病人电转复后左房收缩功能的观察。方法：应用彩色多普勒超声心动图对２０例房颤病人转复窦性心率者于复律后１小时，２４小时，２周，及４周分别测量二尖瓣口舒张期血流频谱的Ａ峰流速，判定房颤转复后心房收缩功能的恢复过程。结果：１５例病人二尖瓣血流频谱Ａ峰流速电转复后１小时０．３０±０．１０ｍ／ｓ增至第４周０．６２±０．１４ｍ／ｓ（Ｐ＜０．００１）；２例病人２４小时Ａ峰流速恢复正常且大于Ｅ峰流速；１例病人至转复后４周仍未出现Ａ峰。另２例病人转复后一周复颤，其中１例未出现Ａ峰，１例仅出现低小的Ａ峰，且不随时间变化。结论：房颤转复后左房机械功能出现“顿抑”，从而提供临床房颤转复后应给予适当的抗凝治疗。

Objective:To observe the restoration of left atrial systolic function after electrical conversion of atrial fibrillation.Method:In 20 patients with atrial fibrillation,Doppler color echocardiographic examination was performed to measure A peak flow rate using diastolic blood flow frequency spectrum at the mitral orifice,1h,24h,2 and 4 weeks after conversion of atrial fibrillation to sinus rhthm.Result:The A peak flow rate increased from 0.30±0.10m/s at 1h to 0.62±0.14m/s at 4 weeks after conversion in 15 cases ( P <0.001);returned to normal and became more rapid than E peak flow rate in 2 cases.A peak did not appear within 4 weeks after conversion in one case.Atrial fibrillation recurred one week after conversion in the remaining two cases,with A peak absent in one case and A peak being low,small and unchanged with time in the other.Conclusion:Appropriate anticoagulant therapy should be used following conversion in consideration of a highly possible depression of the left atrial mechanical function after clinical electrical conversion of atrial fibrillation.