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目的探讨左房压力(LAP)与心房颤动(AF)发生和维持的关系。方法 90例初次行导管射频消融术(RFCA)的AF患者,分为阵发性AF(paro-AF)组46例,持续性AF(per-AF)组44例,术中描记LAP波形并测量LAP。paro-AF组记录初始窦性心律时LAPSNR和诱发出AF3min时的LAP3min,per-AF组记录初始AF节律下的LAPPer。结果 AF发作时及per-AF转复窦律后急性期LAP波形的a波均消失。paro-AF组LAP3min高于LAPSNR[(18.30±8.62)mm Hg vs.(13.33±6.55)mm Hg](P<0.05),per-AF组较paro-AF组AF诱发前后的LAP均增高[(21.77±8.72)mm Hg vs.(13.33±6.55)mm Hg、(21.77±8.72)mm Hg vs.(18.30±8.62)mm Hg](P<0.05)。结论 AF发作时及per-AF转复窦律后急性期左房均无主动收缩功能。LAP升高可能是AF发生和维持的机制之一。
Objective To investigate the relationship between left atrial pressure (LAP) and the occurrence and maintenance of atrial fibrillation (AF). Methods Totally 90 AF patients undergoing RFCA were divided into 46 patients in paro-AF group and 44 patients in per-AF group. The LAP waveforms were recorded intraoperatively and measured LAP. In the paro-AF group, LAPSNR at the initial sinus rhythm and LAP3min at AF3min were recorded, and LAPPer at the initial AF rhythm was recorded in the per-AF group. Results A wave of LAP waveform disappeared at the onset of AF and per-AF sinus rhythm. The LAP3min in paro-AF group was higher than that in LAPSNR group [(18.30 ± 8.62) mmHg vs (13.33 ± 6.55) mmHg], P <0.05) 21.77 ± 8.72 mmHg vs. 13.33 ± 6.55 mmHg, and 21.77 ± 8.72 mmHg vs. 18.30 ± 8.62 mmHg, respectively) (P <0.05). Conclusions There is no active systolic function in left atrium during AF and per-AF sinus rhythm after acute sinus rhythm. Elevated LAP may be one of the mechanisms of occurrence and maintenance of AF.