P波离散度预测阵发性心房颤动射频消融术后复发的价值

【目的】探讨阵发性房颤射频消融术后复发的预测因素。【方法】145例行环肺静脉导管射频消融术的阵发性房颤患者，记录术前及术后心电图，测量最大、最小P波时限，计算P波离散度。【结果】术后平均随访（6．1±0．2）个月，根据是否复发房颤分为复发组51例和未复发组94例。复发组较未复发组的术前最大P渡时限增大[（120．2±11．0）ms比（105．6±7．8）ms，P〈0．001]；P波离散度明显增大[（53．6±6．2）ms比（39．9±4．7）ms，P〈0．001]；两组P波最小时限及其他临床指标均无统计学差异。多因素分析示术前P波离散度≥46ms（P=0．04）和发作频率≥5次／月（P=0．01）是房颤复发的预测因素，二者预测复发的灵敏度分别是87％和86％；特异度92％和85％。【结论】术前P波离散度及房颤发作频率一定程度上可预测阵发性房颤射频消融术后的复发。

Value of P Wave Dispersion in the Prediction of the Recurrence of Paroxysmal Atrial Fibrillation after Radiofrequency Ablation

[Objective]To explore the predictive factors of the recurrence of paroxysmal atrial fibrillation （PAF） after radiofrequency ablation. [Methods]Totally 145 PAF patients undergoing circumferential pulmonary vein radiofrequency catheter ablation were enrolled in this study. The electrocardiogram before and after operation were recorded. The maximum and minimum P wave duration were measured. The P wave dispersion was calculated. [Results] The average time of follow up after operation was 6. 1 ± 0.2 months. All patients were divided into recurrence group（ n = 51） and non-recurrence group（ n = 94）. Compared with non-recurrence group, the maximum P wave duration and dispersion before operation in recurrence group increased [-（120.2±11.0）msvs. （105.6±7.8）ms, （53.6±6.2）ms vs. （39.9±4.7）ms, allPd0.001]. There was no significant difference in the minimum P wave duration and other indicators between two groups. Multivariate analysis showed that preoperative P wave dispersion≥46ms（ P = 0. 04） and the frequency,5 times per month（ P =0.01） were independent predictors of the recurrence of PAF, and the sensitivity in predicting the recurrence of PAF was 87% and 86%, respectively, and the specificity was 92% and 85%, respectively. [Conclusion]The P wave dispersion and the frequency of atrial fibrillation can predict PAF recurrence after radiofrequency ablation to some extent.