老年人左房内径对房颤复律及窦律维持的影响

Influence of internal diameter of left atrium on rhythmic conversion from atrial fibrillation and maintenance of sinus rhythms in elderly patients

目的研究胺碘酮在老年房颤（Af）复律及以后维持窦性心律的疗效与左心房内径（LA）大小之间的关系。方法67例老年慢性阵发性Af患者，经心动超声图检测后，根据左房内径分成两组。A组30例：LA〈40mm；（29．7—39．8）（37．42±2．58）mm；B组37例：LA≥40mm；（40．8±52．7）（45．89±2．87）mm。观察2年，其主要终点为Af复发。结果Af颤的转复律，A组为95．42％，B组为73．17％沪〈0．01）；窦性心律维持率，A组为61．52％，B组为50．14％沪〈0．01）。结论老年人左心房内径的大小与Af复律的成功率密切相关，并能根据左心房内径的大小来估计Af复发的危险性大小，从而指导Af的治疗。

Objective To observe the efficacy of amiodarone on rhythmic diversion from atrial fibrillation and maintenance of sinus rhythms in elderly patients, and discuss the relationship between this efficacy and the internal diameter of the left atrium. Methods 67 patients with chronic atrial fibrillation were divided to two groups according to the internal diameter of the left atrium as measured by echocardiography. Group A included 30 patients, whose mean internal diameter of the left atrium ranged from 29.7 to 39.8mm （mean 37.42±2.58mm）. Group B included 37 patients, whose mean internal diameter of the left atrium ranged from 40.8 to 52.7mm （mean 45.89 ±2.87mm）. The patients were followed up about 2 years. The primary end point was recrudescence of atrial fibrillation. Results The diversion rate from atrial fibrillation was 95.13% in group A versus 73.17 % in group B group （P〈0.01）. The rate of maintaining sinus rhythms was 61.52% in group A versus 50.14% in group B （P〈 0.01）. Conclusion The internal diameter of the left atrium is likely to influence successful diversion from atrial fibrillation and could be used to predict the risk of recrudescence of atrial fibrillation in elderly patients.