Characteristics of ambulatory electrocardiography in elderly patients with non-valvular atrial fibrillation complicating long RR interval and treatment efficacy of circumferential pulmonary vein isolation
Abstract：ObjectiveT o analyze the characteristics and clinical significance of ambulatory electrocardiography (AECG) in the elderly patients with non-valvular atrial fibrillation (NVAF) complicating long RR interval, and to explore the treatment efficacy of radiofrequency ablation. Methods We selected 532 elderly patients with NVAF treated in our hospital and performed 24-hour AECG monitoring. According to the presence or absence of long RR interval, they were divided into long RR interval group (399 cases) and non-long RR interval group (133 cases). The ventricular rate, arrhythmia, left ventricular function, etc. were compared between the two groups, and so were heart rate, conversion of AF, etc. before and after circumferential pulmonary vein isolation (CPVI). Results
In the long RR interval group, the average, the slowest and the fastest ventricular rate during sleep time are all higher than those during non-sleep time while the number of long RR intervals is significantly lower (P<0.05). The level of C-reactive protein in the long RR interval group is lower than that in the non-long RR interval group, and the incidence of atrial premature beats and arrhythmia are higher than those in the nonlong RR interval group (P<0.05). In the patients with RR interval over 3.0 s, the incidence of seconddegree atrioventricular block, paroxysmal atrial tachycardia, and complete or incomplete right bundle branch block are lower than those in the patients with RR interval of 2.0-3.0 s while the incidence of transient ventricular arrest is higher (P<0.05). The average and the fastest ventricular rate of the patients decrease after CPVI while the slowest ventricular rate increases, and the long RR interval disappears (P<0.05). Conclusion Elderly patients complicated by NVAF and long RR interval are prone to arrhythmia, atrial premature beats, and ventricular rate acceleration. AECG monitoring can provide references for CPVI treatment on these patients.
徐鸿远，钟国强，李霖，李金轶. 老年非瓣膜性房颤合并长RR间期的动态心电图特点及环肺静脉电隔离术治疗效果[J]. 实用心电学杂志, 2022, 31(1): 43-48.
XU Hongyuan, ZHONG Guoqiang, LI Lin, LI Jinyi. Characteristics of ambulatory electrocardiography in elderly patients with non-valvular atrial fibrillation complicating long RR interval and treatment efficacy of circumferential pulmonary vein isolation. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2022, 31(1): 43-48.
