心电射频消融术复律治疗急性冠状动脉综合征伴频发性室性早搏患者的临床效果

Clinical Efficacy of Radiofrequency Ablation of Electrocardiogram in the Treatment of Acute Coronary Syndrome with Frequent Ventricular Premature Beats

目的探讨急性冠状动脉综合征(ACS)伴频发性室性早搏(FVPB)患者采用心电射频消融术(CRA)复律治疗的临床效果。方法选取2021年4月至2022年12月在商丘市第一人民医院接受治疗的ACS伴FVPB患者共计86例,根据随机数字表法分为研究组(n=43,CRA复律治疗)与对照组(n=43,常规药物复律治疗),对两组室性早搏频率、心功能[左心室收缩末内径(LVESD)、左心室舒张末内径(LVEDD)、左心室射血分数(LVEF)]、心率变异性指标[低频功率(LF)、高频功率(HF)、心率变异性正常N-N间期的标准差(SDNN)、相邻N-N间期差值均方根(rMSSD)]及血清水平[C反应蛋白(CRP)、N-端脑利钠肽前体(NT-proBNP)]进行比较。结果两组治疗后室性早搏频率降低,且研究组较对照组更低,差异有统计学意义(P<0.05);两组治疗后LVESD、LVEDD降低,LVEF提高,且研究组LVESD、LVEDD较对照组更低,LVEF更高,差异有统计学意义(P<0.05);两组治疗后LF、HF、SDNN、rMSSD提高,且研究组较对照组更高,差异有统计学意义(P<0.05);两组治疗后CRP、NT-proBNP水平降低,且研究组较对照组更低,差异有统计学意义(P<0.05)。结论CRA复律治疗ACS伴FVPB患者,能够降低室性早搏频率,改善心功能,缓解心率变异指标,降低CRP、NT-proBNP水平。

Objective To investigate the clinical effect of cardiofrequency ablation(CRA)in patients with acute coronary syndrome(ACS)with frequent ventricular premature beat(FVPB).Methods A total of 86 patients with ACS and FVPB who received treatment in the First People's Hospital of Shangqiu City from April 2021 to December 2022 were selected and divided into a study group(n=43,CRA reversion therapy)and a control group(n=43,conventional drug reversion therapy)according to random number table method.Ventricular premature beat frequency,heart function[left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)],heart rate variability index[low-frequency power(LF),high-frequency power(HF),standard deviation(SDNN)of N-N interval with normal heart rate variability,and adjacent N-N interval difference root mean square(rMSSD)]and serum levels[C-reactive protein(CRP),N-telencephalic natriuretic peptide precursor(NT-proBNP)]were compared.Results After treatment,the frequency of ventricular premature beats was lower in the study group than in the control group,the difference was statistically significant(P<0.05).After treatment,LVESD and LVEDD were decreased and LVEF was increased in the two groups,LVESD and LVEDD in the study group were lower and LVEF was higher than that in the control group,the difference was statistically significant(P<0.05).After treatment,LF,HF,SDNN,and rMSSD were increased in two groups,and the study group was higher than the control group,the difference was statistically significant(P<0.05).After treatment,the levels of CRP and NTproBNP in the two groups were decreased,and the study group was lower than the control group,the difference was statistically significant(P<0.05).Conclusion CRA cardioversion therapy in ACS patients with FVPB can reduce ventricular premature beat frequency,improve cardiac function,relieve heart rate variability index,and reduce CRP and NT-proBNP levels.