Clinical Study On Heart Rate Control And Hemodynamics In Elderly Patients With Persistent Atrial Fibrillation

Objective:The clinical characteristics of hemodynamics in elderly patients with persistent atrial fibrillation were evaluated by non-invasive hemodynamic monitor,and the relationship between heart rate control and hemodynamics was discussed.Method:A total of 192 outpatients and hospitalized patients aged over 60 years in the Department of Cardiology and Geriatrics of the First Hospital of Shanxi Medical University from August 2017 to August 2018 were selected.According to the inclusion criteria,they were divided into atrial fibrillation group(157 cases)and non-atrial fibrillation group(35 cases).The resting heart rate control level of AF group was divided into relaxed heart rate control group(80 beats/min < heart rate < 110 beats/min,55 cases),strict heart rate control group(heart rate < 80 beats/min,53 cases),poor heart rate control group(heart rate < 110 beats/min,49 cases).The hemodynamics of Qianfan CSM3000non-invasive hemodynamic detector was monitored.Before monitoring,the basic information of subjects(including age,sex,height,weight,etc.)was collected;the patients with atrial fibrillation were also collected the history of atrial fibrillation and the level of resting heart rate control;during monitoring,the hemodynamic indexes of patients were recorded: cardiac output(CO),cardiac index(CI),cardiac volume(SV),stroke index(SI),left ventricular stroke work(LSW),and so on.Left ventricular stroke work index(LSWI),pre-ejection per(PEP),stress state index(ISI),left ventricular ejection time(LVET),systolic blood pressure(SBP),diastolic blood pressure(DBP),mean blood pressure(MAP)and so on.Result:1.According to statistical analysis,there was no significant difference in age,height,weight,medical history and so on.CO,CI,SV,SI,LSW,LSWI,ISI and LVET in AF group were lower than those in non-AF group(P < 0.05),PEP in the group of AF was longer than that in non-AF group(P < 0.05),SBP,DBP and MAP indices in the group of AF and non-AF were no significantly different(P > 0.05).2.In the atients with atrial fibrillation,CO,CI,SV,SI,ISI were lower than those in the group of relaxed and strict heart rate control(P < 0.05),LSW,LSWI,PEP in the group of poor heart rate control was longer than those in the group of relaxed and the strict heart rate control(P < 0.05),LVET,SBP,DBP and MAP were no significant difference no significant difference between the three groups.3.There was no significant difference between the relaxed heart rate control group and the strict heart rate control group(P > 0.05).Conclusion:1.The hemodynamics of elderly patients with atrial fibrillation is different from that of non-atrial fibrillation patients.2.When the resting heart rate of elderly patients with persistent atrial fibrillation is controlled less than 110 beats/min,the hemodynamics is more stable than that of patients with resting heart rate control more than 110 beats/min,and the left ventricular function can be improved,which has certain guiding significance for the evaluation of the cardiac function of elderly patients with persistent atrial fibrillation.3.In the treatment of elderly patients with atrial fibrillation,there is no significant difference in hemodynamic parameters between the relaxed heart rate control group and the strict control group,and the relaxed heart rate control is easier to achieve than the strictheart rate control during the treatment,which plays a guiding role in the individualized treatment of elderly patients with persistent atrial fibrillation.