肺静脉电隔离对阵发性心房颤动患者P向量环的影响

目的探讨成功的肺静脉电隔离对心房除极的影响。方法记录接受环肺静脉电隔离术的18例阵发性心房颤动(PAF)患者术前及术后第1天窦性心律时的心向量图。测量P环的运行时间、P向量环在正交导联额面(F)、水平面(H)、左侧面(LS)的最大振幅及方向。同时记录P环从运行开始后每10ms的除极振幅。结果肺静脉隔离术后P环F最大振幅较术前降低(0.109±0.038mVvs0.128±0.040mV,P0.05)。P环运行时间,H及LS的最大振幅,F、H、LS的最大振幅方向,术前术后无差异(P0.05)。消融成功组(n=12)术后P环H最大振幅较术前降低(0.092±0.019mVvs0.122±0.030mV,P0.05),而术后复发组(n=6)则无明显变化。肺静脉隔离术后P环振幅降低发生在P环运行至40～80ms的部分,即P向量环的中部。结论PAF病人在肺静脉电隔离成功后P环最大振幅发生改变。

The effect of pulmonary vein isolation on the P loops in patients with paroxysmal atrial fibrillation

Objective To investigate the effect of puhnonary vein （PV） isolation on atrial depolarization. Methods Eighteen patients with paroxysmal atrial fibrillation （PAF） underwent PV isolation procedures. Vectorcardiograms in sinus rhythm were recorded before and after procedures. Then the duration, the maximal amplitude and angle in frontal（F） , horizontal（H） and left-side（LS） plane of P loops were measured. Furthermore, the amplitude was determined at every 10 ms （ 10, 20, …, 110 ms） of P duration from the beginning of P loop. Results The maximal amplitude of P loops in frontal plane after PV isolation was significantly lower than that of before procedures （ 0. 109 ± 0. 038 mV vs 0. 128 ± 0.040 mV, P 〈 0.05 ）. However, other parameters including the duration, the maximal amplitude in H and LS plane and angle in all three planes of P loops didn＇t change. Patients with successful PV isolation showed a significant reduction of the maximal amplitude of P loops in F plane from 0. 122 ± 0. 030 mV to0. 092 - 0. 019 mV （P 〈 0.05 ）. In contrast, no change was noted in patients with recurrence. The amplitude during 40 - 80 ms of P duration （ the middle part of P loops） decreased after PV isolation. Conclusions The maximal amplitude of P loops in patients with PAF changs after successful PV isolation.