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目的应用24h动态心电图观察阵发性房颤发作的特征,进一步了解阵发性房颤的启动机制。方法阵发性房颤患者55例,观察房颤发作开始有无触发性房早,并测量其偶联间期(CI)及早搏指数(PI);记录触发性房早在V1导联的极性;观察房颤发作前是否存在心动过缓事件。结果阵发性房颤共计128阵。90.6%的阵发性房颤发作前均可见触发性房早,其联律间期(464±53ms)及早搏指数(0.41±0.06)明显短/小于非触发性房早(CI为509±50ms,p<0.05;PI为0.54±0.09,p=0.002)。92.2%的触发性房早其V1导联P波呈正向(+),提示左房起源。87.5%的阵发性房颤发作前存在心动过缓,其中69.6%为房早后的代偿间期,余为窦性心动过缓。结论阵发性房颤绝大多数由房早诱发,且触发性房早的联律间期更短,早搏指数更小;大部分阵发性房颤发作前存在心动过缓,且以房早后的代偿间期为主,其次为窦性心动过缓。
Objective To observe the characteristics of paroxysmal atrial fibrillation by 24h Holter to further understand the mechanism of paroxysmal atrial fibrillation. Methods Fifty-five patients with paroxysmal atrial fibrillation (AF) were enrolled in this study. The incidence of atrial premature atrial fibrillation onset was observed. The CI and PI were measured. Sex; observed before the onset of atrial fibrillation bradycardia event. Results A total of 128 paroxysmal atrial fibrillation. Triggering atrial premature beats were seen in 90.6% of patients with paroxysmal atrial fibrillation. The duration of intercourse (464 ± 53ms) and premature beats index (0.41 ± 0.06) were significantly shorter / shorter than those of non-trivial atrial premature beats (CI 509 ± 50ms , p <0.05; PI was 0.54 ± 0.09, p = 0.002). 92.2% of the triggering room as early as V1 lead P wave was positive (+), suggesting that left atrial origin. 87.5% of patients with paroxysmal atrial fibrillation before the onset of bradycardia, of which 69.6% of the room for the compensatory interval, more than sinus bradycardia. Conclusion The vast majority of paroxysmal atrial fibrillation induced by atrial early, and trigger atrial septal shortened intercourse shorter, premature beats index is smaller; most paroxysmal atrial fibrillation before the onset of bradycardia, After the compensation interval based, followed by sinus bradycardia.