肺静脉隔离术对阵发性心房颤动合并慢快综合征患者窦房结功能的影响

Impact of pulmonary vein isolation on the sinus node function in patients with paroxysmal atrial fibrillation and brady-tachy arrhythmia syndrome

目的:探讨肺静脉隔离术对阵发性心房颤动(房颤)合并慢快综合征患者窦房结功能的影响。方法:入选于我院行肺静脉隔离术的阵发性房颤合并窦房结功能障碍的患者[校正的窦房结恢复时间(CSNRT)≥550 ms],共31例。所有患者于术前、术后2 d及术后6个月进行24 h动态心电图检查,测定平均心率、最慢心率及最快心率,测定心率变异性指标rMSSD、SDNN,并于术后6个月采用食管调搏的方法测定CSNRT,比较手术前后各项指标的变化。结果:与术前相比,患者术后2 d及术后6个月的平均心率、最慢心率及最快心率均有明显上升(P<0.05);术后6个月测定CSNRT较术前有明显缩短(P<0.05);与术前相比,患者术后2 d及术后6个月的rMSSD、SDNN均明显缩短(P<0.05)。结论:阵发性房颤伴窦房结功能障碍的患者经肺静脉隔离术后,窦房结功能明显恢复,迷走神经张力明显减弱。

Objective：To study the impact of pulmonary vein isolation on the sinus node function in patients with paroxysmal atrial fibrillation and brady-tachy arrhythmia syndrome. Methods：A total of31 patients with paroxysmal atrial fibrillation and brady-tachy arrhythmia syndrome [corrected sinus node recover time（CSNRT）≥550 ms]who had received radiofrequency ablation in our hospital were selected.All patients received 24-hour Holter tests before ablation,2 days after ablation and 6 months after ablation.The mean heart rate,minimal heart rate and maximal heart rate were tested.The heart rate variability tests were done,which concluded rMSSD and SDNN.These indexes were compared before and after ablation.The CSNRTs were tested by TEAP 6 months after ablation. Results：Compared with the indexes before ablation,the mean heart rate,minimal heart rate and maximal heart rate 2 days after ablation and 6 months after ablation were rised obviously（P〈0.05）,the CSNRT6 months after ablation was shortened obviously（P〈0.05）.Compared with the indexes before ablation,the rMSSD and SDNN were shortened obviously 2 days after ablation and 6 months after ablation（P〈0.05）. Conclusion：After pulmonary vein isolation,the sinus node function is obviously recovered in paroxysmal atrial fibrillation patients with sinus node dysfunction.The vagal tone is weakened obviously.