老年患者双腔起搏器置入术后发生心房颤动的相关因素分析

Investigatingthe related factors for atrial fibrillation in elderly patientsafter implantation of dual-chamber pacemaker

目的:研究老年患者双腔(DDD型)起搏器置入术后发生心房颤动的相关因素。方法:回顾性分析2012年9月至2014年9月,在北京安贞医院首次置入DDD型永久起搏器,65岁及以上的老年患者261例,起搏器术后常规程控随访至2年,读取起搏器内存储信息,记录心房、心室起搏百分比,心房高频事件(AHRE)发生的时间及频率,分析发生心房颤动的危险因素。结果:共入组261例患者,平均年龄为(70.3±5.0)岁,男性149例,女性112例,起搏器程控随访(24.0±2.3)个月,共67例发生心房颤动(25.7%),进行Logistic多因素分析结果显示:年龄(OR:1.166,95%CI:1.09~1.25,P<0.05),高血压(OR:3.240,95%CI:1.57~6.68,P<0.05)、左心房内径(OR:1.145,95%CI:1.05~1.25,P<0.05)、心室起搏百分比(OR:1.037,95%CI:1.01~1.06,P<0.05)是心房颤动发生的独立危险因素。结论:年龄、高血压、左心房内径、心室起搏百分比与老年患者双腔起搏器置入术后心房颤动发生密切相关。

Objective：To study the related factors of atrial fibrillation after implantation of dual-chamber （DDD） pacemaker in elderly patients. Methods： Retrospective study 261 patients aged 65 and older patients ,who implantDDD permanent paeemakerfor the first time in BeijingAn Zhen Hospital from September 2012 to September 2014. Clinical data were collected, the conventional programmable pacemaker implantation were followed up to 2 years, included in the final statistics a total of 261 patients, read the information stored in the pacemaker. Record the percentage of atrial and ventricular pacing, atrial high-frequency event （AHRE） , anal- ysis the risk factors of atrial fibrillation. Results： A total of 261 patients were enrolled, the average age was （70. 3 ±5） years old, 149 male cases, 112 femalecases, follow-up 24. 0±2. 3 months, 67 cases of atrial fibrillation （25.7%）, logistic multi factor analysis showed that age （ OR： 1. 166,95% CI： 1.09 - 1.25, P 〈 0.05 ）. Hypertension （ OR： 3. 240,95% CI： 1.57 - 6. 68, P 〈 0. 05 ）, left atrial diameter （ OR： 1. 145,95% C1：1.05 - 1.25, P 〈 0.05 ） , the percentage of ventricular pacing （ OR ： 1. 037, 95% CI： 1.01 - 1.06, P 〈 0. 05 ） are independent risk factors for atrial fibrillation. Conclusion：Age, hypertension, left atrial diameter and the percentage of ventrieular pacing were closely related to the occurrence of atrial fibrillation after dualchamber pacemaker implantation in elderly patients.