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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Predictors of atrial defibrillation threshold in internal cardioversion.
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Predictors of atrial defibrillation threshold in internal cardioversion.

机译：内部心脏复律时房颤除颤阈值的预测因子。

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摘要

This study examined the clinical, echocardiographic, and electrophysiological factors influencing the atrial defibrillation threshold (ADFT) in patients with chronic, persistent AF undergoing transvenous, low energy, atrial cardioversion. Twenty-two patients (age 57 +/- 15 years) with a mean AF duration of 7.8 +/- 7.1 months (range 2-32 months) underwent internal cardioversion with catheters placed in the right atrium and coronary sinus. Biphasic shocks (3/3 ms) were delivered in a step-up protocol. ADFT was defined as the lowest energy shock that converted AF to sinus rhythm. All patients were successfully cardioverted at a mean ADFT of 5.62 +/- 2.82 J (range 2.6-12.9 J). Fifteen variables, including clinical characteristics (age, body mass index, AF duration, etiology), echocardiographic measurements (atrial diameter and volumes, indexes of ventricular performance), hemodynamic measurements, and mean atrial cycle during AF were analyzed as possible predictors of ADFT. In univariate regression analysis, AF duration, mean RR interval, and cardiac index correlated with ADFT. In multivariate regression analysis, AF duration remained as the only significant predictor of ADFT (B coefficient 0.311, P < 0.001; 95% confidence interval [CI] 0.194-0.427). AF duration was the most powerful predictor of ADFT. It should be considered when planning internal CV of AF to limit the number of shocks delivered. Furthermore, long intervals between AF onset and CV should be avoided.
机译：这项研究检查了慢性，持续性房颤患者行经静脉，低能量，房性心脏复律的患者的临床，超声心动图和电生理因素是否会影响房颤除颤阈值（ADFT）。 22名平均AF持续时间为7.8 +/- 7.1个月（2-32个月）的患者（年龄57 +/- 15岁）接受了内部心脏复律，并在右心房和冠状窦内放置了导管。双相电击（3/3 ms）以升压方案进行。 ADFT被定义为将AF转换为窦律的最低能量冲击。所有患者均以5.62 +/- 2.82 J（范围2.6-12.9 J）的平均ADFT成功进行了心脏复律。分析了15个变量，包括临床特征（年龄，体重指数，AF持续时间，病因），超声心动图测量（心房直径和体积，心室性能指标），血液动力学测量以及AF期间的平均心房周期，以作为ADFT的可能预测指标。在单变量回归分析中，AF持续时间，平均RR间隔和心脏指数与ADFT相关。在多元回归分析中，AF持续时间仍然是ADFT的唯一重要预测指标（B系数0.311，P <0.001; 95％置信区间[CI] 0.194-0.427）。 AF持续时间是ADFT最有力的预测指标。在计划自动对焦的内部CV时应考虑限制发送的电击次数。此外，应避免AF发作和CV之间的间隔过长。

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