风湿性心脏病慢性房颤心房扩大与心房电生理的相关性研究

目的:探讨风湿性心脏病慢性房颤左房内径大小对心房电生理特性的影响。方法:选择风湿性心脏病慢性房颤患者16例,术前采用超声心动图测量左心房内径,采用心外膜标测技术测量心房有效不应期(AERP)和波长指数(WLI),并与左房内径行相关性分析。结果:慢性房颤患者左房内径和右房压力明显高于窦性心律患者(P<0.05),左房内径与AERP和WLI呈负相关(r=-0.882和-0.745)。结论:风心病慢性房颤左心房扩张影响心房的电生理特性,提示左心房的扩张引起心房结构重构,并影响心房的电生理重构而导致房颤的发生和维持。

The relationship of atrial dilatation and cardiac electrophysiologic characteristics of chronic atrial fibrillation in rheumatic heart disease

Objective To investigate the effect of atrial inner dimension on atrial electrophysiologic characteristics of chronic atrial fibrillation in rheumatic heart disease.Methods The left atrial inner dimension,atrial effective refractory period (AERP) and atrial wavelength index(WLI) of 16 patients with chronic atrial fibrillation in rheumatic heart disease,were measured by ultrasonic cardiogram and intraoperative epicardial mapping respectively.The left atrial inner dimension were correlated analyzed with AERP and WLI.Results The left atrial inner dimension and right artial pressure in chronic atrial were significantly higher than those in sinus rhythm group (P < 0.05).The left atrial inner dimension was negatively correlated with AERP and WLI.Conclusion The left atrium dilatation of chronic fibrillation in rheumatic heart disease,has a significant effect on atrial electrophysiologic characteristics,which suggested that the atrium dilatation lead to structural reconstruction of the atrium,influence electrophysiologic remodeling,hence contribute to initiation and maintenance of atrial fribillation.