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目的通过观察左房线性消融术治疗阵发性心房颤动(简称房颤)术后心率变异性(HRV)的变化来评价其对自主神经系统的影响。方法对25例行射频消融术的阵发性房颤患者,术前及术后第3天行24h动态心电图检查,分别测定最大心率,最小心率,平均心率;时域指标:RR间期标准差(SDNN),RR间期平均值的标准差(SDANN),相邻RR间期差的均方根(RMMSD),相邻RR间期差值超过50ms的RR间期所占百分数(PNN50);频域指标:低频功率(LF),高频功率(HF),低频高频比值(LF/HF)。结果患者术前最大心率,最小心率,平均心率,SDNN,SDANN,RMSSD,PNN50,LF,HF,LF/HF分别为151±41次/分,47±5次/分,70±9次/分,126±26ms,111±24ms,27±7ms,6±5ms,98±66ms2,86±119ms2,2.4±3.5;术后各指标分别为136±37次/分,66±8次/分,84±9次/分,57±17ms,53±17ms,16±7ms,2±3ms,18±19ms2,16±19ms2,1.2±1.6;手术前后各指标相比,差异有显著性(P均<0.05)。结论左房线性消融术后HRV降低,此可能是射频消融治疗房颤的机制之一。
Objective To evaluate the effects of left atrium linear ablation on the changes of heart rate variability (HRV) after paroxysmal atrial fibrillation (AF). Methods Twenty-five patients with paroxysmal atrial fibrillation who underwent radiofrequency ablation were examined by Holter monitoring before operation and on the third day after operation. Maximum and minimum heart rate and mean heart rate were measured respectively. Time domain indices: standard deviation of RR interval (SDNN), standard deviation of average RR interval (SDANN), root mean square (RMMSD) of adjacent RR interval and percentage of RR intervals with adjacent RR intervals over 50ms (PNN50); Frequency Domain Indicators: LF, HF, LF / HF. Results The preoperative maximum heart rate, minimum heart rate, mean heart rate, SDNN, SDANN, RMSSD, PNN50, LF, HF and LF / HF were 151 ± 41 beats / minute, 47 ± 5 beats / minute and 70 ± 9 beats / , 126 ± 26ms, 111 ± 24ms, 27 ± 7ms, 6 ± 5ms, 98 ± 66ms2, 86 ± 119ms2,2.4 ± 3.5 respectively. The indexes of postoperative were 136 ± 37 beats / min, 66 ± 8 beats / 57 ± 17ms, 53 ± 17ms, 16 ± 7ms, 2 ± 3ms, 18 ± 19ms2, 16 ± 19ms2,1.2 ± 1.6 respectively. There was significant difference between before and after operation (P <0.05) ). Conclusions HRV decreases after left atrial ablation, which may be one of the mechanisms of radiofrequency ablation for atrial fibrillation.