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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >The prognostic significance of atrial arrhythmias recorded early after cardioversion for atrial fibrillation.
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The prognostic significance of atrial arrhythmias recorded early after cardioversion for atrial fibrillation.

机译：复律后早期记录的房性心律失常对房颤的预后意义。

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摘要

In a substantial number of patients, AF recurs after successful electrical cardioversion. The purpose of this study was to investigate if the atrial arrhythmias recorded immediately after cardioversion are associated with the risk of recurrence of the arrhythmia and to compare the prognostic significance of this parameter with that of other established risk factors. In a series of 71 patients, the risk factors for recurrence of AF during the first year after successful electrical cardioversion were analyzed. A new parameter that was investigated was the frequency of atrial premature beats and the presence of runs of supraventricular tachycardia in the Holter recording started immediately after the cardioversion. Age, left atrial size, left ventricular systolic function, duration of the arrhythmia before cardioversion, underlying cardiac disease, or medication taken were not found to be predictive of recurrence of the arrhythmia. However, the natural logarithm of the number of atrial premature complexes per hour of the Holter recording in the 37 patients in whom AF recurred was higher compared to that of the 34 patients who maintained sinus rhythm (P < 0.0005). The same was true if only the first 6 hours of the recording were analyzed (P < 0.0005). There was a trend for more frequent arrhythmia recurrence if runs of supraventricular tachycardia were present. The finding of > 10 atrial premature complexes per hour in the recording had a relative risk of 2.57 (1.51-4.37), a positive predictive accuracy of 76.5%, and a negative predictive accuracy of 70.3% for subsequent arrhythmia recurrence. We can conclude that frequent (> 10/hour) atrial premature complexes in the Holter recording after electrical cardioversion for AF is a significant risk factor for recurrence of the arrhythmia.
机译：在许多患者中，成功进行电复律后，AF会复发。这项研究的目的是调查心脏复律后立即记录的房性心律失常是否与心律失常复发的风险相关，并将该参数与其他已确定的危险因素的预后意义进行比较。在71例患者中，分析了成功进行电复律后第一年房颤复发的危险因素。研究的一个新参数是心房早搏的频率和动态恢复后立即开始的动态心电图记录中室上性心动过速的出现。年龄，左心房大小，左心室收缩功能，心脏复律前心律失常的持续时间，潜在的心脏疾病或所用药物未发现可预测心律失常的复发。然而，在37例AF复发患者中，每小时动态心电图记录的心房早搏复合物的自然对数高于保持窦性心律的34例患者（P <0.0005）。如果仅分析记录的前6小时，则情况也是如此（P <0.0005）。如果存在室上性心动过速，则心律失常的复发趋势会更加频繁。每小时在记录中发现的> 10个心房早搏复合物，相对风险为2.57（1.51-4.37），阳性预测准确率为76.5％，阴性心律失常复发的预测准确度为70.3％。我们可以得出结论，AF心脏电复律后动态心电图记录中频繁出现的（> 10 /小时）心房过早复合物是心律失常复发的重要危险因素。

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