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目的探讨持续性心房颤动(简称房颤)患者左房电压基质情况以指导持续性房颤的导管射频消融。方法80例持续性房颤(Pers-AF组)、30例阵发性房颤(Paro-AF组)及10例左侧旁道患者(对照组)在窦性心律下完成左房电压基质和激动标测。左房分为7个区域进行统计分析电压、区域传导激动指数和标测面积。结果左房低电压区和/或疤痕区在房颤患者中检出阳性率仅为12.7%(14/110,Paro-AF组2例,Pers-AF组12例),PersAF和Paro-AF两组低电压区和/或疤痕区的阳性率比较无统计学差异(15%vs 6.7%,P=0.34)。相比于对照组,其他两组患者左房平均电压显著低,大部分区域激动传导缓慢。此外,Pers-AF组左房电压降低较Paro-AF组患者显著。结论房颤患者左房平均电压显著降低并传导缓慢,以Pers-AF患者为甚,低电压区和/或疤痕区可能是持续性房颤维持基质。
Objective To investigate the situation of left atrium voltage matrix in patients with persistent atrial fibrillation (AF) to guide the radiofrequency catheter ablation of persistent atrial fibrillation. Methods Eighty patients with persistent atrial fibrillation (Pers-AF group), 30 patients with paroxysmal atrial fibrillation (Paro-AF group) and 10 patients with left bypass (control group) Excitement mapping. Left atrium is divided into seven regions for statistical analysis of voltage, regional conduction index and mapping area. Results The positive rate of left atrial low voltage area and / or scar area in AF patients was 12.7% (14/110, 2 in Paro-AF group and 12 in Pers-AF group), 2 in PersAF and Paro-AF There was no significant difference in the positive rates between the low voltage area and the scar area (15% vs 6.7%, P = 0.34). Compared with the control group, left atria average voltage was significantly lower in the other two groups, and most of the region was slow to conduct. In addition, the decrease of left atrial voltage in Pers-AF group was more significant than that in Paro-AF group. Conclusion The average left atrium voltage is significantly decreased and conduction is slow in patients with AF, especially in Pers-AF patients. The low voltage area and / or scar area may be the persistent matrix of AF.