26例心房颤动患者心律转复前后心肺运动试验分析

目的探讨心房颤动对心脏功能的影响及心房颤动患者转复心律前后摄氧量等运动参数的改变。方法采用美国MedGraphics公司心肺运动仪和活动平板,在Bruce改良方案的基础上,对26例心房颤动患者分别进行心律转复前后心肺运动试验。结果26例心房颤动患者心律转复后,静息心率(HRrest)平均由109次min减慢到83次min(P<0001),最大运动时心率(HRmax)平均由182次min减慢到141次min(P<0001);最大每搏摄氧量(VO2maxHR)平均由788mL提高到109mL(P<0001);运动总时间(TET)平均由81min增加到88min(P<0001);最大运动速度(Speed)平均由30mph增加到33mph(P<001);斜度(Elevation)由1315%提高到1385%(P<001),试验过程中无并发症发生。结论心房颤动患者转复窦性心律后,心率明显减慢,最大每搏摄氧量增加,运动时间延长,运动耐力提高,心功能得到改善。

Cardiopulmonary exercise capacity before and after cardioversion of atrial fibrillation in 26 patients

Objective:To assess the effect of atrial fibrillation on heart function and observe the changes of exercise parameters before and after cardioversion of atrial fibrillation. Method:The cardiopulmonary exercise tests were performed in 26 patients with atrial fibrillation according to the modified Bruce protocol befter and after cardioversion of atrial fibrillation. Result:After cardioversion of atrial fibrillation the heart rate decreased from 182/min to 141/min and 109/min to 83/min( P <0 001) respectively at peak exercise and rest. The amount of oxygen uptake per heartbeat (VO 2max/HR), treadmill walking time, maximal exercise velocity and elevation significantly increased from 7 88 mL to 10 9 mL( P <0 001),8 1 min to 8 8min( P <0 001),3 0 mph to 3 3 mph( P <0 01) and 13 15% to 13 85% ( P <0 01), respectively. No complication occurred during exercise. Conclusion: Cardioversion of atrial fibrillation can increase oxygen uptake per heartbeat and exercise tolerance, heart rates slow down ,and improve heart function in patients with atrial fibrillation.