在鼻腔节律中测绘P波的身体表面映射,以预测心房动心房动后的复发
Ibrahim Antoun1, Xin Li2, Ahmed Kotb3
1Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, United Kingdom.
Frontiers in cardiovascular medicine
|August 9, 2024
概括
持续性心房动 (persAF) 的直流心脏转变 (DCCV) 的成功可以通过P波持续时间来预测. 在服用阿米奥达龙的患者中,经校正的P波持续时间 (PWDc) 超过161毫秒,表明DCCV后AF复发的可能性更高.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗技术 医疗技术 医学技术
背景情况:
- 直流心转 (DCCV) 是对心房动 (AF) 的主要节律控制策略.
- 预测DCCV对持续性AF (persAF) 的长期成功仍然是一个临床挑战.
- 通过身体表面映射 (BSM) 获得的P波参数可以提供有关心转后AF复发的见解.
研究的目的:
- 调查BSM测量的P波参数对12个月DCCV成功的预测值在persAF患者中.
- 评估P波持续时间,振幅和分散与AF复发之间的关联.
- 评估阿米奥达龙使用对这些P波参数预测能力的影响.
主要方法:
- 一项涉及56名接受DCCV治疗的男性患者的病例控制研究.
- 使用128个单极导线测量DCCV后的P波参数,包括修正的P波持续时间 (PWDc).
- 进行了统计分析,包括接收机操作员特征 (ROC) 曲线分析,以确定12个月结果的预测因素.
主要成果:
- 整体12个月DCCV成功率为44%;其余患者在2.6个月内恢复到AF.
- 在整体队列中,P波参数在成功和失败的DCCV之间没有显著差异,也没有在非阿米奥达龙的患者中.
- 在阿米奥达龙使用者中,在失败的DCCV患者中观察到更高的PWDc (188 ms vs. 150 ms,P=0.04).
- 在阿米奥达龙组中对PWDc的ROC分析显示AUC为0.75 (P=0.049),截止值>161ms预测复发,敏感度为69%和特异性为100% (HR=10.7,P=0.004).
结论:
- 通过BSM测量的P波持续时间 (PWDc) 的增加与在DCCV后12个月的AF复发风险增加有关,这些患者正在服用阿米奥达龙.
- 在这种特定的患者亚组中,PWDc可以作为预测DCCV结果的有价值的生物标志物.
- P波参数无法预测AF复发的时间.
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