The impact of left atrial pressure on filtered P-wave duration in patients with atrial fibrillation
The impact of left atrial pressure on filtered P-wave duration in patients with atrial fibrillation
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DOI：
10.1007/s00380-015-0789-3
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发表时间：
2016-11-01
影响因子：
1.5
通讯作者：
Masuyama, Tohru
中科院分区：
文献类型：
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作者：
Kishima, Hideyuki;Mine, Takanao;Masuyama, Tohru
左心房大小正常的房颤患者滤过P波时限（FPD）延长的原因尚不清楚。我们研究了在无明显左房扩大的房颤患者中，FPD是否与左房压（LVEF）相关。本研究包括80例（48例男性，年龄65 ± 9岁，25例持续性房颤）非瓣膜性房颤患者，他们接受了房颤导管消融（CA）。在CA期间测量窦性心律下的心率，并在CA后记录信号平均心电图。我们回顾性评估了临床和超声心动图变量。FPD延长定义为FPD> 120 ms。在23/80例患者（29%）中检测到FPD延长（FPD> 120 ms）。根据单变量分析，平均舒张压较高（14.9 ± 4.4 vs. 10.8 ± 3.5 mmHg，p <0.0001）、持续性心律失常患病率较高、BNP较高、LAD较大、E波较高和LVEF较低与FPD延长相关。根据多变量分析，平均舒张压较高是与FPD延长相关的唯一因素（p = 0.0058，平均舒张压每增加1 mmHg，OR 1.256，95% CI 1.068 - 1.476）。此外，在FPD和平均屈光度之间观察到显著相关性（r = 0.503，p <0.0001）。在无明显左心房扩大的房颤患者中，FPD延长与高房颤相关。左心房压力超负荷可引起心房电活动减慢。
The cause of prolonged filtered P-wave duration (FPD) remains unclear in atrial fibrillation (AF) patients with normal left atrial size. We investigated whether FPD is associated with left atrial pressure (LAP) in AF patients without prominent LA enlargement. This study included 80 patients (48 men, age 65 +/- 9 years, 25 persistent AF) with non-valvular AF who underwent catheter ablation (CA) for AF. LAP was measured in sinus rhythm during CA and signal-averaged electrocardiogram was recorded after CA. We retrospectively assessed the clinical and echocardiographic variables. Prolonged FPD was defined as FPD > 120 ms. Prolonged FPD (FPD > 120 ms) was detected in 23/80 patients (29 %). According to univariate analysis, higher mean LAP (14.9 +/- 4.4 vs. 10.8 +/- 3.5 mmHg, p < 0.0001), higher prevalence of persistent arrhythmia, higher BNP, larger LAD, higher E wave, and lower LVEF were associated with Prolonged FPD. According to multivariate analysis, higher mean LAP was the only factor associated with Prolonged FPD (p = 0.0058, OR 1.256 for each 1 mmHg increase in mean LAP, 95 % CI 1.068-1.476). Moreover, a significant correlation was observed between FPD and mean LAP (r = 0.503, p < 0.0001). Prolonged FPD is associated with high LAP in AF patients without prominent left atrial enlargement. Pressure overload of the left atria might cause slowing of atrial electrical activation.