起搏术后心房颤动的影响因素及心房颤动与心钠素的关系

目的观察心脏起搏术后发生心房颤动(简称房颤)的影响因素及房颤与血心钠素(ANP)的关系。方法选择安装心脏起搏器的患者103例进行随访,分析房颤与年龄、起搏方式、心律失常类型、左房内径(LAD)、左室射血分数(LVEF)和血ANP的关系。结果①65岁以下患者房颤发生率低于65岁以上组(P<0.05)。②VVI组房颤发生率高于DDD组(P<0.05)。③慢快综合征组房颤发生率较缓慢型病窦综合征和房室传导阻滞组高(P<0.05)。④VVI房颤组术后LAD增大、LVEF下降(P<0.05),VVI房颤组术后与DDD组比较有差异(P<0.05)。⑤VVI房颤组和VVI窦性心律组ANP浓度较DDD组高(P<0.05);各组不同心功能级别(NYHA)之间ANP浓度随着心功能级别的加重而升高。结论长期心脏起搏术后房颤的发生可能与年龄大、VVI起搏、病窦综合征(慢快型)、LAD增大、LVEF降低及ANP浓度升高相关。

Influence factors of atrial fibrillation and relation between atrial fibrillation and plasma atrial natriuretic peptide in paced patients

Objective To observe influence factors of atrial fibrillation(AF) and relation between AF and plasma atrial natriuretic peptide(ANP) in paced patients. Methods 103 patients with the pacemaker were selected .They were followed up for 2.54±2.47 years . The influence factors of AF were analysised. Results The patients more than 65 years old had higher incidence of AF than those younger (P<0.05). ②The incidence of AF was higher in patients with ventricular pacing than in those with atrial pacing (P<0.05).③ The patients with bradycardia-tachycardia syndrome(BTS) had higher incidence of AF than those with other arrhythmia (P<0.05).④Left atrial dimension(LAD) of VVI follow-up group with AF in postoperative was obviously larger than that in preoperative (P<0.05). The left ventricular ejection fraction(LVEF) of VVI follow-up group with AF in postoperative was obviously lower than that in preoperative (P<0.05). There was obviously difference between VVI follow-up group with AF and DDD group in postoperative (P<0.05). ⑤The difference of the plasma ANP concentration between the VVI group with AF and sinus rhythm to DDD group was significant(P<0.05). The plasma ANP concentration was increased from cardiac function grade Ⅰto grade Ⅲ. Conclusions The incidence of AF is obviously related to old age , VVI mode , BTS ,large of LAD ,the decrease of LVEF and the rise of the plasma ANP concentration in patients with long-term cardiac pacing.