环肺静脉线性消融术对P波时限及麦氏指数的影响

目的探讨环肺静脉线性消融术对P波时限和麦氏指数的影响。方法选择50例行环肺静脉线性消融的阵发性心房颤动患者,描记消融术前及术后7天窦性心律下同步12导联心电图,分析比较各导联P波时限及麦氏指数。术后定期根据症状及动态心电图随访判断手术成功与否,并比较成功者与复发者手术前后的P波时限及麦氏指数。结果Ⅱ、Ⅲ、aVR、V3、V4、V5导联P波时限术后缩短(P<0.05);Ⅱ、aVR、V3、V4、V6导联麦氏指数术后减小(P<0.05);手术后成功者与复发者P波时限和麦氏指数无差异。结论环肺静脉线性消融术后,体表心电图一些导联中P波时限及麦氏指数减小;术后P波时限及麦氏指数对手术是否成功无预测价值。

Changes in P-wave duration and Macruz index after circumferential pulmonary vein isolation.

Objective To study the influence of circumferential pulmonary vein isolation （CPVI） on P-wave duration （PWD） and Macruz index. Method Fifty patients with paroxysmal atrial fibrillation （AF） underwent CPVI. For each patient, an ECG recording was taken before and 7 days after ablation. PWD and Macruz index were measured. Successful outcome after CPVI was defined as free of symptomatic and asymptomatic AF at the end of two consecutive follow-ups. Results PWD was shortened in leads of Ⅱ , Ⅲ, aVR, V3, V4, V5 after ablation （ P 〈 0.05 ）. Macruz index was decreased in leads of Ⅱ , aVR, V3, V4, V6 after ablation （P 〈0.05）. Both PWD and Maeruz index had no difference between success group（n = 39） and failure group （ n = 11 ）. Conclusion CPVI results in PWD and Macruz index shortening in several leads. PWD and Macruz index have no value in predicting success or failure of CPVI.