阵发性心房颤动发作对窦性心率振荡的影响

The effect of paroxysmal atrial fibrillation on sinus heart rate oscillation

目的探讨阵发性心房颤动(简称房颤)对窦性心率振荡是否产生影响。方法阵发性房颤来源于动态心电图数据库。对符合24h内发作的阵发性房颤,且在发作起始前和终止后均有1h窦性心率的患者为研究对象。采用时间RR间期(t-RR)散点图及逆向技术分析并测量房颤发生前1h及终止后1h窦性心率Lorenz-RR散点图的短、长轴的长度及面积,并比较清醒和睡眠状态发作下其参数的变化。结果27例患者入选本研究,其中清醒状态下发作房颤16例[男9例,女7例,年龄(68±9)岁];睡眠状态下发生11例[男9例,女2例,年龄(75±11)岁]。房颤发作前1h及终止后1hLorenz-RR散点图的短轴宽度比较有显著差异[67(48,92)vs 60(40,82);P=0.027]。在清醒状态下,阵发性房颤发生前1h及终止后1hLorenz-RR散点图短轴宽度比较有差异[67(54,88)vs 78(38,84);P<0.05],其面积比较亦有差异[24245(15888,53154)ms2 vs 22228(11852,34793)ms2;P<0.05];而睡眠时则没有差异性(P>0.05)。结论阵发性房颤发作改变原有窦性心率振荡幅度,其程度可能与是否清醒状态有关。

Objective To investigate the effect of paroxysmal atrial fibrillation(PAF)on sinus heart rate(SR)oscillation.Methods PAF originated from the database of dynamic electrocardiogram.PAF was recorded within 24 hours and SR was recorded 1hour before the onset of PAF and 1hour after the termination of the attack.Using time RR interval(t-RR)scatter plot and reverse technique to obtain Lorenz-RR scatter plot.The length of the short and long axis of Lorenz-RR plot for 1hour SR were measured before and after PAF,and the area of Lorenz RR scatter plot for one hour is calculated.The parameters of Lorenz-RR scattergram for 1hour SR were compared between awake and sleep state.Results Twenty seven patients were enrolled in this study,including 16patients[9males,7females,age(68±9)years]with AF in awake state and 11patients[9males,2females,age(75±11)years]in sleep state.There was a significant difference in the short axis width of Lorenz RR scattergram before and after PAF[67(48,92)vs 60(40,82);P=0.027].In awake state,there was a difference in the width of the short axis of 1 hour Lorenz-RR before and after PAF[67(54,88)vs 78(38,84);P<0.05],and there was also a difference in the area[24245(15888,53154)ms2 vs 22228(11852,34793)ms2;P<0.05],while there was no difference in sleep state(P>0.05).Conclusion PAF can change the amplitude of the original SR oscillation,and the extent may be related to whether the patients are awake or not.