心房总传导时间与阵发性心房颤动射频消融术后复发的关系

The relationship between total atrial conduction time and recurrence of paroxysmal atrial fibrillation after radiofrequency catheter ablation

目的探讨心房总传导时间(TACT)与阵发性心房颤动(简称房颤)导管射频消融术(RFCA)后复发的关系。方法入选2012~2014年行RFCA的阵发性房颤患者116例,TACT测定即在术前基础心律为窦性心律时,脉冲多普勒采样容积放在二尖瓣环上的左房侧壁,从体表心电图Ⅱ导联P波的起始时间至组织多普勒追踪A’波波峰的时间(PA-TDI)间期,测定3个心动周期,取其平均值,术后3个月空白期后评定治疗效果并随访6个月。根据随访结果将患者分成复发组和未复发组。结果随访结束,116例患者中29例(25%)患者复发,复发组TACT较未复发组长[(144±23)ms vs(124±20)ms,P<0.001)],多因素分析发现TACT是预测阵发性房颤RFCA术后复发的独立因素(OR=1.045,95%CI 1.021~1.073,P<0.001)。结论 TACT可用于预测阵发性房颤射频消融术后复发。

Objective To investigate the relationship between total atrial conduction time（TATC） and recurrence of paroxysmal atrial fibrillation after radiofrequency catheter ablation （RFCA）. Methods 116 patients with parox- ysmal atrial fibrillation who underwent RFCA from 2012 to 2014 were enrolled in this study, when patients were in sinus rhythm before RFCA,TACT was estimated by measuring the time delay between the onset of the P-wave in lead 11 of the surface electrocardiogram and the peak A-wave on the tissue Doppler tracing of the left atrial lateral wall （PA-TDI duration）, 3 cardiac cycles were measured and their mean values were determined. Clinical success was assessed after 3-month blanking period and all patients were follow-up for 6 months. According to the results of the follow-up, the patients were divided into recurrent group and unrecurrentgroup. Results In the end of follow-up period,29 patients（25%） suffered from recurrent AF. Univariate analysis showed that the mean TACT of the recurrent group of patients was longer than that of the unrecurrent group of patients[（144 ± 23）ms vs （124 ± 20）ms, P 〈 0.001 ]. Multivariable analysis revealed that TACT was an independent risk factor responsible for the recurrence of AF（OR= 1.045, 95%CI 1.021--1.073,P〈0.001）. Conclusion TACT can be used to predict the recurrence of paroxysmal atrial fibrilla- tion after RFCA.