原发性高血压伴阵发性心房颤动患者触发性房性期前收缩的电生理研究

目的研究高血压伴阵发性心房颤动（PAf）患者触发性房性期前收缩（简称触发性房早）的电生理特点。方法分析2008年4月至2011年3月经动态心电图确诊的46例高血压伴PAf患者（高血压组）触发性房早起源部位和早搏指数（PI）,并与35例非高血压PAf患者（非高血压组）相比较。结果高血压组PAf患者触发性房早主要来源于左心房（81．6％）。高血压组触发性房早联律间期（374．1±31．5）ms明显短于高血压组非触发性房早[（443．6±32．6）ms,￡=23．361,P〈0．001]及非高血压组的触发性房早[（395．7±38．2）ms,t=5．549,P〈0．001];PI（0．50±0．05）明显低于非触发性房早（0．63±0．06,t=22．544,P〈0．001）,也低于非高血压组的触发性房早（0．55±0．08,t=5．849,P〈0．001）。结论高血压伴PAf患者触发性房早主要起源于左心房,触发性房早PI明显低于非高血压伴PAf患者。高血压患者更易并发PAf。对于房早PI较低的高血压患者,应及时处理房早,以防止PAf的发生。

Electrophysiological features of triggering atrial premature contraction in patients with hypertension combined paroxysmal atrial fibrillation

Objective To explore the electrophysiologieal features of triggering atrial premature contraction（APC） in patients with hypertension combined paroxysmal atrial fibrillation （PAf）.. Methods The originating sites and prematurity index（PI） of triggering APC were analyzed in 46 PAl patients with hypertension （hypertension group）and in 35 PAf patients without hypertension（ non-hypertension group）from April,2008 to March,2011 in Shanghai Punan Hospital of Pudong New District. Results Triggering APCs in 46 eases with hypertension combined PAf in the hypertension group originated mainly in the left atrium（81.6% ）. The coupling interval （CI）of triggering APC in hypertension group was significantly shorter than that in non-triggering APC （ [ 374. 1 ± 31.5 ] ms versus [ 443.6 ± 32. 6 ] ms, t = 23. 361, P 〈 0. 001 ） and that in triggering APC in non- hypertensive group （ [374. 1 ±31.5]ms versus [395.7 ±38. 2]ms,t =5. 549 ,P 〈0. 001 ）. PI in triggering APC was lower than that in non-triggering APC in hypertension group（0. 50 ±0. 05 versus 0. 63 ±0.06,t =22. 544, P 〈 0. 001 ）and that in triggering APC in non-hypertension group （0. 50 ± 0. 05 versus 0. 55 ± 0.08, t = 5. 849, P 〈 0. 001 ）. Conclusion The triggering APC in patients with hypertension combined PAl mainly originates in the left atrium, the PI of triggering APC is significantly lower than that in non-hypertension patients with PAf and PAf occurs more easily in patients with hypertension. Prompt measures should be taken for hypertension patients with lower prematurity index to prevent the occurrenee of PAI.