阵发性房颤患者心率减速力的变化及其临床意义.

Objective To investigate the changes and clinical significance of deceleration capacity of rate(DC) in patients with paroxysmal atrial fibrillation(PAF). Methods Ninety patients diagnosed with PAF(PAF group) were selected from the inpatients in our hospital from January 2015 to October 2016 while 133 healthy subjects were selected as control group. They underwent 24-hour ambulatory electrocardiography and echocardiography examinations. Between the two groups, their DC, acceleration capacity of heart rate(AC), heart rate variability(HRV), left atrial diameter(LAD) and left ventricular ejection fraction(LVEF) were compared and analyzed. [WTHZ]Results(ⅰ) Compared with the control group, DC value, absolute value of AC, SDNN, rMSSD and LAD all significantly increased in PAF group(P<0.05) while the 24hour average heart rate and LF/HF both significantly decreased(P<0.05). (ⅱ) There was no significant difference of DC value between males and females in either group. However, if compared with the same sex in the control group, DC value of males in PAF group significantly increased(P<0.05) while the value showed an increasing trend in females. (ⅲ) Whether in the control group or in PAF group, DC value was negatively correlated with age(r<－0.262 vs. r<－0.548，P<0.01). If compared with those in the same age subgroup of the control group, the DC value of the patients younger than 60 years old in PAF group significantly increased(P<0.05) while the value showed an increasing trend in those older than 60 years old. (ⅳ) The LAD value of patients in PAF group was significantly higher than that in control group(P<0.05). However, the DC values in PAF group were both significantly higher than those in control group(P<0.05) whether for those with LAD≤40 mm or those with LAD>40 mm. Conclusion Increased DC value in PAF patients suggests increased tension of vagus nerve. The index is negatively correlated with age of patients. [ABSTRACT FROM AUTHOR]