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目的:分析阵发性心房颤动(AF)患者,肺静脉隔离(PVI)前后P向量环的变化,探讨PVI所致的局部心房电静止能否影响心房除极向量。方法:阵发性AF患者65例,采用肺静脉口外节段性隔离,于手术前后窦性心律时分别记录心电向量图,分析心房除极向量的P环总运行时间(Pd)、额面P环电压(Pfv)、横面P环电压(Phv)、右侧面P环电压(Psv),以及额面P环角度(Pfd)、横面P环角度(Phd)和右侧面P环角度(Psd)。65例患者术中均达即刻成功标准,无并发症发生。结果:PVI前后心电向量图P环各项指标无明显变化[Pd为(113.3±1.4)msvs.(112.1±1.4)ms;Pfv为(0.15±0.01)mVvs.(0.15±0.01)mV;Phv为(0.11±0.00)mVvs.(0.12±0.00)mV;Psv为(0.14±0.01)mVvs.(0.14±0.01)mV;Pfd为(55.2±2.2)°vs.(53.0±1.7)°;Phd为(43.1±2.6)°vs.(45.9±2.7)°;Psd为(55.4±1.9)°vs.(54.4±2.0)°]。结论:PVI治疗阵发性AF,造成肺静脉所在的左心房部分心肌产生心电静止,不影响心房除极的P向量环变化。
PURPOSE: To analyze the changes of P vector rings in patients with paroxysmal atrial fibrillation (AF) before and after pulmonary vein isolation (PVI), and to investigate whether PVI-induced local atrial electrocorticography can affect the atrial depolarization vector. Methods: Sixty-five patients with paroxysmal AF were enrolled in this study. The segmental segmental pulmonary venous isolation was performed. The electrocardiogram (ECG) was recorded before and after sinus rhythm. The total P-epicyclic activity (Pd) Pfv, Phv, Psv, and Pfd, Phd and P-ring angles of the frontal plane, (Psd). 65 patients were up to instant success criteria, no complications. Results: There was no significant change in P-ring before and after PVI [Pd (113.3 ± 1.4) ms vs (112.1 ± 1.4) ms and Pfv (0.15 ± 0.01) mV vs (0.11 ± 0.00) mVvs. (0.12 ± 0.00) mV; Psv was (0.14 ± 0.01) mVvs. (0.14 ± 0.01) mV; Pfd was (55.2 ± 2.2) ° vs (43.1 ± 2.6) ° vs (45.9 ± 2.7) °; Psd was (55.4 ± 1.9) ° vs (54.4 ± 2.0) °. Conclusions: PVI treatment of paroxysmal AF, resulting in pulmonary venous part of the left atrium myocardial electrocardiogram produced static, does not affect the atrial depolarization P vector ring changes.