环肺静脉线性消融术对P波时限及离散度的影响

Changes in P-wave duration and P-wave dispersion after circumferential pulmonary vein isolation

目的对比环肺静脉线性消融术前、术后P波时限和P波离散度,发现环肺静脉线性消融对以上参数的影响。方法 50例阵发性房颤患者,描记消融术前及术后7天窦性心律下同步12导联心电图,分析比较各导联P波时限及P波离散度,术后定期根据症状及动态心电图随访判断手术成功与否。结果 P波时限:Ⅱ、Ⅲ、aVR、V3、V4、V5导联P波时限术后较术前缩短(p<0.05),P波时限术后成功组与复发组间比较均无统计学差异;P波离散度术后较术前减小(p<0.05),术后复发组较成功组离散度偏大(p<0.05);P波指数术前、术后无统计学差异,术后复发组较成功组P波指数偏大(p<0.05)。结论环肺静脉线性消融术可改善房颤患者P波离散程度,P波离散度和P波指数可作为术后房颤复发的预测指标。

Objective To study the influence of circumferential pulmonary vein isolation（CPVI） on P-wave duration（PWD） and P-wave dispersion and investigate whether changes were associated with successful outcome after initial CPVI.Method Fifty patients with paroxysmal atrial fibrillation（AF） underwent CPVI.For each patient,an ECG recording was taken before and 7 days after ablation.PWD and P-wave dispersion were measured.Successful outcome after CPVI was defined as freedom from symptomatic and asymptomatic AF at the end of two consecutive follow-ups.Results PWD was shortened in lead Ⅱ、Ⅲ、aVR、V3、V4、V5 after ablation（p0.05）.PWD was not different between successes（n=39） and failures（n=11） after ablation.P-wave dispersion was decreased after ablation（p0.05）.Both P-wave dispersion and P-wave index were different between successes and failures after ablation（p0.05）.Conclusion CPVI results in shortening in PWD and decreasing in P-wave dispersion.Both P-wave dispersion and P-wave index were provided with predictive value between success and failure after ablation.