P波间期与阵发性房颤首次射频消融术后复发的关系

Predictive value of P-wave duration and dispersion in atrial fibrillation recurrence after first successful pulmonary vein isolation for paroxysmal atrial fibrillation

目的 评价P波间期对阵发性房颤射频消融术后复发的影响.方法 100例药物治疗无效的症状性阵发性房颤患者,在Ensite Velocity三维标测系统指导下行环肺静脉前庭线性消融,消融终点为肺静脉电隔离.结果 术中肺静脉隔离率100％.术后随访（14.0±5.5）个月,其中72例成功维持窦性心律（窦律维持组）,28例复发（复发组）.复发组最大P波间期及P波离散度均较窦律维持组明显延长[最大P波间期：（138±16）mm比（126±14）mm,P波离散度：（58±21）mm比（49±15）mm],两组差异有统计学意义.结论 阵发性房颤射频消融术前标准体表12导联心电图（ECG）所测的最大P波间期及P波离散度可预测术后复发.

Objective To evaluate the association of P-wave duration and dispersion on standard 12 lead ECG with atrial fibrillation recurrence post pulmonary vein isolation.Methods We selected 100 patients with symptomatic drug-refractory paroxysmal atrial fibrillation undergoing circumferential pulmonary vein isolation guided by the Ensite Velocity system with the three-dimensional geometric reconstruction.Results 72 （72%） patients maintained sinus rhythm while recurrences occurred in 28 （28%） patients.The patients that had atrial fibrillation recurrence had longer P-wave duration [（138±16）mm vs （126±14）mm,P=0.006] and larger P-wave dispersion [（58±21）mm vs （49± 15）mm,P=0.025] than those that maintained sinus rhythm.Conclusion P-wave duration and dispersion are good clinical predictors of atrial fibrillation recurrence post pulmonary vein isolation in patients with paroxysmal atrial fibrillation.