摘要
目的旨在探讨双腔起搏器植入患者新发心房颤动的昼夜节律和季节分布特点。方法回顾性收集2015年1月至2020年12月在首都医科大学附属北京天坛医院心脏中心术前无心房颤动史的157例双腔起搏器植入患者的程控资料,主要分析新发心房颤动发作的时间特点。心房颤动事件定义为起搏器腔内心电图记录到心房率>250次/min,心室波形态同窦律一致,但心室率不规整,持续时间≥30 s。定义上午时间区间为06:00—11:59;下午为12:00—16:59;晚上为17:00—22:59;凌晨为23:00—05:59。结果平均随访(1515±540)d结果显示,38例(24.2%)双腔起搏器植入患者检出新发心房颤动,中位检出新发心房颤动的时间为996 d(四分位间距:679 d,1204 d)。新发心房颤动检出的高峰时段为上午(18例,47.4%),其次为凌晨时间段(10例,26.3%),下午和晚上检出新发心房颤动出现概率最低,均为5例(13.2%)。另外,随访期内这38例患者共记录到121次心房颤动发作,平均发作次数为(3.2±1.9)次,发作次数最多的峰值在凌晨00:00—02:59时间区间,共计34次(28.1%),其次上午08:00—10:59为第二峰值,共21次(17.4%),晚上17:00—19:59为心房颤动发作最少的时间段,共计3次(2.5%)。季节分布来看,新发心房颤动出现比例最高的为冬季(15例,39.5%),其次为春季(11例,28.9%),最低为秋季(5例,13.2%)。结论永久性双腔起搏器植入患者术后新发心房颤动存在昼夜节律和季节分布的特点,新发心房颤动检出的高峰时间段为上午,高峰季节为冬季。
objective To explore the circadian variation and seasonal distribution of new onset atrial fibrillation(AF)in patients after permanent dual pacemaker implantation.Methods The program control data of 157 patients without a history of AF receiving dual pacemaker in Beijing Tiantan Hospital from January 2015 to December 2020 were retrospectively collected,the temporal characteristics of new onset AF were analyzed.AF was diagnosed if the atrial electrogram rate was>250 bpm,electrogram were disorganized,and the ventricular electrogram morphology was similar to baseline for a minimum duration of 30 seconds.The morning period was defined as 06:00 to 11:59,afternoon as 12:00 to 16:59,evening as 17:00 to 22:59,and the wee hours as 23:00 to 05:59.Results During(1515±540)days of follow-up,38(24.2%)patients with double chamber pacemaker implantation developed new onset AF.The median detection time of new onset AF was 996(inter-quartile range:679-1204)days.The peak time for detection of new onset AF is morning period(18 cases,47.4%),followed by wee hours(10 cases,26.3%),the incidence of new onset AF was the lowest in the afternoon and evening,with 5 cases in both(13.2%).Besides,during the follow-up period,121 atrial fibrillation episodes were recorded in the 38patients,with an average of(3.2±1.9)episodes.Accordingly,the peak of the number of episodes was during 00:00 to 02:59[34 events(28.1%)],the second peak was during 08:00 to 10:59[21 events(17.4%)],17:00 to 19:59 was the period with the fewest AF episodes[3 events(2.5%)].In terms of seasonal distribution,the incidence of new onset AF was highest in winter(15 cases,39.5%),followed by spring(11 cases,28.9%),and lowest in autumn(5 cases,13.2%).Conclusion There is circadian variation and seasonal distribution in new onset AF in patients with permanent dual pacemaker.The peak time of detection of new onset AF was morning,and the peak season was winter.
作者
宋柯
陈威
胡奕然
金泽宁
Song Ke;Chen Wei;Hu Yiran;Jin Zening(Department of Cardiology and Macrovascular Disease,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《心脑血管病防治》
2022年第6期9-13,共5页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
基金
北京市科协金桥工程种子资金项目(ZZ21055)
关键词
心脏起搏
心房颤动
昼夜节律
季节分布
Cardiac pacing
Atrial fibrillation
Circadian variation
Seasonal distribution
