AVNRT与WPW综合征患者的性别分布及房室传导特性

Sex distribution and atrioventricular conduction characteristics in patients with AVNRT or WPW syndrome

目的探讨显性或隐性WPW综合征患者及房室结折返性心动过速(AVNRT)的性别分布及房室传导特性。方法分析经射频消融的255例AVNRT患者,267例显性、160例隐匿性WPW综合征患者的临床特点及各项电生理指标。结果显性WPW综合征中男性多见(68%),隐匿性WPW综合征中无性别差异;AVN-RT患者中女性多见(69%)。消融后30min,显性WPW综合征患者的PR间期(164±26)ms及AH间期(86±20)ms较隐匿性WPW综合征患者[(146±20)ms、(75±15)ms]显著延长(P<0.0001);AVNRT患者消融前的PR间期(144±20)ms及AH间期(75±14)ms短于消融前的隐匿性WPW综合征患者[(150±22)ms、(80±17)ms](P<0.05)及消融后的显性WPW综合征患者[(164±26)ms、(86±20)ms](P<0.0001)。随访中,AVNRT患者的PR间期(144±20)ms也短于显性[(162±25)ms,P<0.0001]或隐性WPW综合征患者[(150±20)ms,P<0.05];AVNRT患者的室房阻滞周长比显性或隐性WPW综合征患者明显缩短。各组经过年龄配对,男女之间PR间期明显不同[(159±22)msvs(150±23)ms,P<0.0001]。结论AVNRT及WPW各组之间存在性别分布不同,各组之间房室传导特性及房室传导的年龄差异可能解释性别分布的不同。

Objective To delineate the sex distribution and atrioventricular conduction properties in patients with manifest or concealed Wolf-Parkinson-White syndrome (WPW) and atrioventricular nodal reentrant tachycardia (AVNRT).Methods The study comprised 255 patients with AVNRT,267with manifest,and 160 with concealed WPW who underwent radiofrequency ablation. Results A male preponderance was observed in patients with manifest WPW (68%),but not in those with concealed WPW (51%),and female preponderance in AVNRT patients(69%).The PR(164±26)ms and AH (86±20)ms intervals obtained 30 minutes after ablation in manifest WPW patients were significantly longer than in concealed WPW patients[(146±20)ms,(75±15)ms,P<0.0001]. The PR(144±20)ms and AH intervals(75±14)ms measured before ablation in AVNRT patients were shorter than those obtained before ablation in concealed WPW patients[(150±22)ms,(80±17)ms,P<0.05]and after ablation in manifest WPW patients[(164±26)ms、(86±20)ms](P<0.0001). The PR interval in AVNRT patients was also shorter than those measured during follow-up in concealed(153±21ms、P<0.05) and manifest WPW patients[(162±25)ms,P<0.0001].The ventriculoatrial block cycle length in AVNRT patients were significantly shorter than in manifest and concealed WPW patients.When age-matched patients were assigned to eath group,significant differences in PR interval were observed between men and women[(159±22)ms,(150±23)ms,P<0.0001].Conclusion Differences in sex distribution exist among patients with concealed and manifest WPW and AVNRT. The atrioventricular properties required for the manifestation of pre-excitation and induction of AVNRT and gender differences in atrioventricular conduction may account for the differences in sex distribution.