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Abstract Objective To investigate the changes and clinical significance of deceleration capacity of rate(DC) in patients with paroxysmal atrial fibrillation(PAF).Methods Ninety patients diagnosed with PAF(PAF group) were selected from the inpatients in our hospital from January 2015 to October 2016 while 133 healthy subjects were selected as control group. They underwent 24hour ambulatory electrocardiography and echocardiography examinations. Between the two groups, their DC, acceleration capacity of heart rate(AC), heart rate variability(HRV), left atrial diameter(LAD) and left ventricular ejection fraction(LVEF) were compared and analyzed. [WTHZ]Results(ⅰ) Compared with the control group, DC value, absolute value of AC, SDNN, rMSSD and LAD all significantly increased in PAF group(P<0.05) while the 24hour average heart rate and LF/HF both significantly decreased(P<0.05). (ⅱ) There was no significant difference of DC value between males and females in either group. However, if compared with the same sex in the control group, DC value of males in PAF group significantly increased(P<0.05) while the value showed an increasing trend in females. (ⅲ) Whether in the control group or in PAF group, DC value was negatively correlated with age(r<－0.262 vs. r<－0.548，P<0.01). If compared with those in the same age subgroup of the control group, the DC value of the patients younger than 60 years old in PAF group significantly increased(P<0.05) while the value showed an increasing trend in those older than 60 years old. (ⅳ) The LAD value of patients in PAF group was significantly higher than that in control group(P<0.05). However, the DC values in PAF group were both significantly higher than those in control group(P<0.05) whether for those with LAD≤40 mm or those with LAD>40 mm. Conclusion Increased DC value in PAF patients suggests increased tension of vagus nerve. The index is negatively correlated with age of patients.
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| [1] 周自强, 胡大一, 陈捷, 等. 中国心房颤动现状的流行病学研究[J]. 中华内科杂志, 2004, 43(7)：491-494.[2]Yu L, Scherlag BJ, Li S, et al. Lowlevel vago sympathetic nerve stimulation inhabits atrial fibrillation inducibility：direct evidence by neural recordings from intrinsic cardiac ganglia[J]. J Cardiovasc Electrophysiol, 2011, 22(4)：455-463.[3] 郭继鸿. 心率减速力检测[J]. 临床心电学杂志, 2009, 18(1)：59-68.[4] Bauer A, Barthel P, Müller A, et al. Risk prediction by heart rate turbulence and deceleration capacity in postinfarction patients with preserved left ventricular function retrospective analysis of 4 independent trials[J]. J Electrocardiol, 2009, 42(6)：597-601.[5] 马长生. 2012年欧洲心脏病学会心房颤动治疗指南更新解读[J]. 中国循环杂志, 2013, 27(Suppl)：6-11.[6] 董宏凯, 邹操, 王枫艳, 等. 扩张型心肌病患者心率加速力和减速力变化的临床意义[J]. 临床心血管病杂志, 2015, 31(7)：769-772.[7] 丁建芬, 刘志红, 王红宇. 正常人心率减速力和心率变异性的变化及相关性[J]. 中国医药科学, 2011, 1(15)：18-19.[8] Akyol A, Alper AT, Cakmak N, et al. Longterm effects of cardiac resynchronization theraphy on heart rate and heart variability[J]. Tohoku J Exp Med, 2006, 209(4)：337-346.[9] 胡亚红, 崔俊玉, 王斌等. 急性心肌梗死患者心率减速力检测的研究[J]. 临床心电学杂志. 2010, 19(4)：250-251.[10] 杨晓云, 左萍, 余彦, 等. 扩张型心肌病患者心率减速力的临床研究[J]. 内科急危重症杂志, 2012, 18(4)：202-204.[11] 曾学寨, 刘德平, 董榕, 等. 自主神经在阵发性心房颤动发生中的作用[J]. 临床心电学杂志, 2007, 16(3)：183-186.[12] 李复. 环肺静脉射频消融术后自主神经功能变化及其对消融效果的影响[J]. 黑龙江医学, 2010, 34(4)：241-243.[13] 彭瑞华, 白梅. 心率减速力检测评估自主神经功能[J]. 临床心电学杂志, 2013, 22(3)：183-185, 189.[14] Huikuri HV, Koistinen MJ, YliMyry S, et al. Impaired lowfrequency oscillation of heart rate in patients with prior acute myocardial infarction and lifethreatening arrhythmias[J]. Am J Cardiol, 1995，76(1)：56-60.[15] Phang RS, Isserman SM, Karia D, et al. Echocardiographic evidence of left atrial abnormality in young patients with lone paroxysmal atrial fibrillation[J]．Am J Cardiol, 2004, 94(4)：511-513. |
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2017, Vol. 26 
