老年心血管病患者房颤反复发作的预测

Predictors of Recurrent Atrial Fibrillation in Elderly Patients with Cardiovascular Disease.

目的 为明确老年心血管疾病患者窦性心律时发生阵发性房颤的危险因素并寻找反复心房颤动发作的预测因子。方法 测量 71例有阵发性房颤发作史的老年心血管疾病患者 (PAF组 )及 73例无阵发性房颤发作史的老年心血管疾病患者 (对照组 )窦性心律时的 12导联ECG ,分别测定最大P波时限 (Pmax)及最小P波时限 (Pmin)并计算其P波离散度 (Pd) ,心脏超声测量左房内径 (LAD)和左室射血分数 (LVEF) ,随访PAF组房颤反复发作情况。结果 PAF组的Pd及Pmax分别为 ( 4 7.0 7± 12 .3 5 )ms和 ( 12 1.2 5± 13 .2 4)ms,较对照组明显延长 (P <0 .0 1) ;PAF组反复房颤发作者 ,Pd≥40ms时相对危险度 3 .3 3 ,Pmax≥ 110ms时相对危险度 2 .48。结论 窦性心律时Pd。

Objective To determine whether elderly patients with cardiovascular diseases at risk for paroxysmal atrial fibrillation(AF)could be detected while in sinus rhythm and search the predictors of recurrent AF.Methods The maximum P-wave duration (Pmax),the minimum P-wave duration (Pmin),P-wave dispersion (Pd=Pmax-Pmin) on 12-leads electrocardiogram and left ventricular effection (LVEF) and left atrial dimension (LAD) on the echocardiogram was measured in 71 patients with history of paroxysmal AF (PAF) and in 73 patients without history of AF (Control),follow-up the recurrence of atrial fibrillation in patents with PAF.Results Pmax,Pd were significantly higher in PAF than Control (Pmax 121.25±13.24 versus 110.38±12.12ms,Pd 47.07±12.35 versus 33.64±8.45ms, P <0.01);Pmax?Pd were significant predictors of PAF.Conclusion Measurement of P wave dispersion in sinus rhythm may be a useful noninvasive clinical tool to identify patients with Cardiovascular disease at risk of developing atrial fibrillation and recurrent atrial fibrillation.