Early repolarization and risk of lone atrial fibrillation
Early repolarization and risk of lone atrial fibrillation
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DOI：
10.1111/jce.13848
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发表时间：
2019-04-01
影响因子：
2.7
通讯作者：
Minamino, Tohru
中科院分区：
文献类型：
--
作者：
Hasegawa, Yuki;Watanabe, Hiroshi;Minamino, Tohru
早期复极综合征是最近提出的一种疾病，其特征是在没有心脏结构性异常的情况下，心电图（ECG）出现早期复极模式和心室颤动。虽然一些研究表明早期复极与房颤的发生频率有关，但早期复极与房颤的关系尚不清楚。假设早期复极化不仅是心房纤颤的基底，也是心房纤颤的基底。方法本研究纳入79例年龄小于60岁的阵发性单纯性心房颤动患者（男性57例[72%]，年龄45 +/- 12岁）和395例年龄和性别匹配的健康对照（患者：对照比1:5）。排除有结构性心脏病、高血压、糖尿病、甲状腺功能亢进、复苏成功史或Brugada型心电图的患者。比较心房颤动患者与健康对照者在窦性心律期间的心电图记录。结果心房颤动患者的下导联和/或侧导联早期复极发生率（25%）高于对照组（10%,P = 0.001）。两组早期复极的位置和强度相似。其他心电图测量在两组之间没有差异。在房颤患者中，早期复极患者与未早期复极患者在房颤发生年龄、性别、体重指数等临床特征上无差异。早期复极患者与未早期复极患者的心电图测量结果无差异。结论早期复极与单发心房颤动有关。早期复极可能表明对房颤的易感性增加。
Introduction Early repolarization syndrome is a recently proposed condition characterized by an early repolarization pattern in the electrocardiogram (ECG) and ventricular fibrillation in the absence of structural heart abnormalities. Although some studies have suggested that early repolarization is associated with frequency of atrial fibrillation, the association of early repolarization with atrial fibrillation is not well known. Hypothesis Early repolarization indicates the substrate for atrial fibrillation in addition to that for ventricular fibrillation. Method This study included 79 patients (57 men [72%]; age, 45 +/- 12 years) aged less than 60 years who had paroxysmal lone atrial fibrillation and 395 age- and sex-matched healthy controls (patient:control ratio, 1:5). Patients who had structural heart disease, hypertension, diabetes, hyperthyroidism, history of successful resuscitation, or the Brugada type ECG were excluded. ECGs recorded during sinus rhythm were compared between patients with atrial fibrillation and healthy controls. Results Early repolarization in the inferior and/or lateral leads was more common in patients with atrial fibrillation (25%) than controls (10%; P = 0.001). The location and magnitude of early repolarization were similar between the two groups. Other electrocardiographic measurements were not different between the two groups. Among patients with atrial fibrillation, there was no difference in clinical characteristics including age at atrial fibrillation development, sex, and body mass index between patients with early repolarization and those without early repolarization. Electrocardiographic measurements were not different between patients with early repolarization and those without early repolarization. Conclusion Early repolarization was associated with lone atrial fibrillation. Early repolarization may indicate increased susceptibility to atrial fibrillation.