To Study Paroxysmal Atrial Fibrillation And Its Related Triggering Factors By 12-leads HOLTER Monitoring And Analysis

Objective To study paroxysmal atrial fibrillation(PAF) and its related atrial arrhythmias and triggering factors by 12-leads HOLTER(12-HOLTER) monitoring and analysis.Methods 12-HOLTER monitoring and analysis were done in the subjects of PAF group(n=47,male=20,female=27,age=64.89±12.70y.) which was subdivided as the triggered PAF subgroup with PAF triggered by atrial arrhythmias and the untriggered PAF subgroup with PAF not triggered by atrial arrhythmias,and of controlled group(n=52,male=22,female=30,age=65.54±9.94y.).The PAF and its related atrial arrhythmias were detected and analyzed by 12-HOLTER.Results(1) Seventy nine events of PAF were found in PAF group by 12-HOLTER; (2) Most of the PAF were triggered by atrial premature(AP)(72/79,91%),a few occurred automatically and suddenly(6/79,8%),and one was triggered by atrial flutter (1/79,1%).(3) The coupling interval of the AP of the triggered PAF subgroup was significantly shorter than that of the untriggered PAF subgroup and controlled group (490±90ms,590±140ms,630±90ms,P＜0.05).The index of AP was smaller significantly in the PAF group than that of the untriggered PAF subgroup and controlled group(0.52±0.12,0.62±0.09,0.71±0.06,P＜0.05).The interval before the AP in PAF group was prolonged significantly than that of controlled group (990±280ms,940±210ms,P＜0.05).(4) During 2min～30s before the PAF occurrence,the AP appeared more frequently(from 0.43 beats/min to 3.5～6.00 beats/min,P＜0.017).(5) The Long-Cycle-Short-Cycle Phenomenon was observed more significantly in PAF group(50.63%,30.56%,9.72%,P＜0.017).(6) Most of the AP which triggered PAF was originated from the upper part of the left atrium (55/72,77%). Conclusions(1) 12-HOLTER can be used to detect PAF and to study the related atrial arrhythmias.(2) AP is a major triggering factor to PAF.(3) The AP which can trigger PAF may be of some of the features such as a shorter coupling interval,a smaller AP index,a longer interval before the AP and the Long-Cycle-Short-Cycle Phenomenon.(4) The AP may take place more frequently within a short time from 2min to 30s before the PAF occurrence.(5) Most of the AP which triggered PAF are originated from the upper part of left atrium.