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目的探讨阵发性心房颤动(简称房颤)患者房颤发作前后、发作时体表心电图QT间期的变化。方法收集35例阵发性房颤患者的24 h动态心电图。测量房颤发作前窦性心律(SRbaseline)、房颤发作、房颤自行转为窦性心律即刻(SRpost AF)时的QT间期。测量连续3个心动周期QT间期。测量每阵房颤的持续时间。分别采用Bazetts、Fridericia和Framingham公式校正QT间期(QTc),分析房颤发作时间与SRpost AF的QTc之间的关系。结果SRpost AF的QTc显著短于SRbaseline的QTc[(407±38)ms vs(435±34)ms;(397±31)ms vs(423±31)ms;(393±35)ms vs(422±30)ms,P均<0.001],而房颤发作时QTc较SRbaseline、SRpost AF的QTc显著性延长[采用三种QT校正公式的QTc分别是(503±69),(454±53),(449±44)ms]。SRpost AF的QTc缩短与房颤短阵发作持续时间无显著相关,与房颤发作前的QT间期相关(相关系数分别是:0.500,0.547,0.507;P均<0.01)。结论房颤发作时QTc显著延长,而房颤发作自行转复窦性心律后QTc显著缩短。
Objective To investigate the changes of QT interval of epicardium before and after atrial fibrillation in patients with paroxysmal atrial fibrillation (AF). Methods The dynamic electrocardiogram of 35 patients with paroxysmal atrial fibrillation was collected 24 hours. Measure the QT interval before SR atrial fibrillation (SRbaseline), atrial fibrillation episode, and atrial fibrillation to SRpost AF. The QT interval was measured for 3 consecutive cardiac cycles. Measure the duration of each atrial fibrillation. The QTc (QTc) was corrected by Bazetts, Fridericia and Framingham formulas, and the relationship between the onset time of atrial fibrillation and QTc of SRpost AF was analyzed. Results The QTc of SRpost AF was significantly shorter than that of SRbaseline [(407 ± 38) ms vs (435 ± 34) ms; (397 ± 31) ms vs (423 ± 31) ms; (393 ± 35) ms vs 30) ms, P <0.001, respectively). However, QTc was significantly longer than SRbaseline and SRpost AF during atrial fibrillation. QTc was (503 ± 69) and (454 ± 53) 449 ± 44) ms]. The QTc shortening of SRpost AF was not significantly correlated with the duration of episodes of atrial fibrillation and was related to the QT interval before episode of atrial fibrillation (correlation coefficients were 0.500, 0.547 and 0.507 respectively; all P <0.01). Conclusions QTc prolonged significantly during the onset of atrial fibrillation, while QTc was significantly shortened after sinus rhythm was reversed by atrial fibrillation.