环肺静脉射频消融术后自主神经功能变化及其对消融效果的影响

The Autonomic Nerves Function of the Atrial Fibrillation Patients after the Radiofrequency Ablation of the Circumferential Pulmonary Vein were Studied

目的用心率变异性评价阵发性房颤患者行肺静脉电隔离后自主神经功能变化及其对消融效果的影响。方法本组37例阵发性房颤患者,年龄在30~72岁,均接受了三维标测系统指导下的环肺静脉射频消融电隔离。术后定期检查24 h动态心电图,记录MaxHR、MeanHR、MiniHR、SDNN、SDANN、rMSSD、LF、HF、LF/HF,并与术前进行比较。结果37例患者均达到消融终点。术后3 d,MaxHR、MeanHR、Mini-HR、LF/HF增高;SDNN、SDANN、rMSSD、LF、HF降低;术后3个月,有35例患者的心率变异性恢复到术前水平,2例患者仍未恢复到术前水平。结论肺静脉电隔离后房颤患者短时间内心率增加、心率变异性降低,3个月后小部分患者仍保持着这种变化,并且伴有消融成功率的提高。

Objective The autonomic nerves function of the atrial fibrillation patients after the radiofrequency ablation（RF） of the.circumferential pulmonary vein were studied.Methods 37 patients aging from 30 to 72 years old were participated in this study.All the patients were received pulmonary vein RF ablation under the guidance of three-dimensional mapping system.The ambulatory electrocardiogram was taken periodically and the parameters of the minimal heart rate,maximal heart rate,average heart rate,SDNN,SDANN,rMSSD,LF,HF and LF / HF were analyzed.All these parameters were compared pre and post the operation.Results 37 patients except one completed the ablation procedure.MaxHR,MeanHR,MiniHR and LF/HF showed increased 3 days postoperation,SDNN、rMSSD、LF and HF were decreased;SDNN、LF、HF、LF/HF、MaxHR、MeanHR、 MiniHR、rMSSD and SDANN were returned to the preoperation level 3 months after the ablation.Conclusion The heart rate of the atrial fibrillation patients increased afer short period of time of circumferential pulmonary vein electrical isolation,heart rate variability decreased,most of patients maintained this change,and so elevated the ablation recovery ratio.