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目的对比环肺静脉线性消融术前、术后P波时限和P波离散度,发现环肺静脉线性消融对以上参数的影响。方法 50例阵发性房颤患者,描记消融术前及术后7天窦性心律下同步12导联心电图,分析比较各导联P波时限及P波离散度,术后定期根据症状及动态心电图随访判断手术成功与否。结果 P波时限:Ⅱ、Ⅲ、aVR、V3、V4、V5导联P波时限术后较术前缩短(p<0.05),P波时限术后成功组与复发组间比较均无统计学差异;P波离散度术后较术前减小(p<0.05),术后复发组较成功组离散度偏大(p<0.05);P波指数术前、术后无统计学差异,术后复发组较成功组P波指数偏大(p<0.05)。结论环肺静脉线性消融术可改善房颤患者P波离散程度,P波离散度和P波指数可作为术后房颤复发的预测指标。
Objective To compare the P wave duration and P wave dispersion before and after circumferential pulmonary vein ablation, and to find out the effect of circumferential ablation on the above parameters. Methods Fifty patients with paroxysmal atrial fibrillation were included in this study. The 12-lead electrocardiogram was recorded before and 7 days after ablation. The P-wave duration and P wave dispersion of each lead were analyzed and compared. According to the symptoms and dynamic ECG follow-up to determine the success of surgery. Results The duration of P wave was shorter than that before operation in group Ⅱ, Ⅲ, aVR, V3, V4 and V5 (P <0.05). There was no significant difference between P group and control group (P <0.05); P wave dispersion was significantly higher than that before operation (P <0.05); P wave index was higher than that of successful group (P <0.05); P wave index had no significant difference before and after operation P wave index in the recurrent group was higher than that in the successful group (p <0.05). Conclusions Circumferential pulmonary vein ablation can improve the degree of P wave dispersion in patients with atrial fibrillation. P wave dispersion and P wave index can be used as predictors for the recurrence of atrial fibrillation.