老年患者双腔起搏器术后心房高频事件的发生率及其危险因素分析

doi:10.3969/j.issn.1003-9198.2026.07.014

摘要/Abstract

摘要： 目的探讨老年患者双腔起搏器术后心房高频事件(atrial high rate episodes,AHREs)的发生率及其危险因素。方法本研究回顾性收集了苏州大学附属第三医院心血管内科2018年4月至2024年9月接受双腔起搏器植入术的107例≥65岁老年患者的临床资料。根据患者有无AHREs,将其分为AHREs组和无AHREs组,探讨老年患者双腔起搏器植入术后AHREs的发生率及其危险因素。结果随访时间中位数为 12(8,15)个月, 在随访期间共有24例(22.4%)患者出现 AHREs;2组间病态窦房结综合征(sick sinus node syndrome, SSS)、左心房容积、心房起搏比例和P波感知振幅比较,差异有统计学意义(P<0.01)。多因素logistic回归分析显示,SSS(OR=4.065,P=0.015)是AHREs的独立危险因素,而较高的P波感知振幅(OR=0.372,P<0.01)是其独立保护因素。ROC曲线分析显示,P波感知振幅预测AHREs的AUC为0.834(P<0.01),截断值为3.85 mV。结论老年患者双腔起搏器植入术后AHREs发生率较高;SSS、P波感知振幅是AHREs的独立影响因素;当P波感知振幅≤3.85 mV时,AHREs的发生风险增加。

关键词: 老年人, 心房高频事件, 双腔起搏器, 病态窦房结综合征, P波感知振幅

Abstract: Objective To investigate the incidence and risk factors of atrial high-rate episodes (AHREs) following dual-chamber pacemaker implantation in elderly patients. Methods This study retrospectively collected the clinical data of 107 patients aged ≥65 years who underwent dual-chamber pacemaker implantation at Department of Cardiovascular Medicine, the Third Affiliated Hospital of Soochow University from April 2018 to September 2024. The patients were divided into AHREs group and non-AHREs group based on the presence of AHREs during follow-up. The incidence and risk factors of AHREs were analyzed. Results During a median follow-up of 12 (8,15) months, AHREs occurred in 24 patients (22.4%). The proportion of sick sinus node syndrome (SSS), left atrial volume, percentage of atrial pacing and P-wave sensing amplitude showed significant differences between AHREs group and non-AHREs group (P<0.01).Multivariable logistic regression analysis revealed that SSS (OR=4.065, P=0.015) was an independent risk factor for AHREs, whereas a higher P-wave sensing amplitude (OR=0.372, P<0.01) served as an independent protective factor.Receiver operating characteristic curve analysis showed that the area under the curve of P-wave sensing amplitude in predicting AHREs was 0.834 (P<0.01), with an optimal diagnostic cut-off of 3.85 mV. Conclusions The elderly patients exhibit a high incidence rate of AHREs following dual-chamber pacemaker implantation; SSS and P-wave sensing amplitude are independent predictors of AHREs; A P-wave sensing amplitude ≤3.85 mV is associated with an increased risk of AHREs.

Key words: aged, atrial high-rate episodes, dual-chamber pacemaker, sick sinus node syndrome, P-wave sensing amplitude

中图分类号:

R 541.74

王梦非, 徐维, 赵蓉, 钱波, 朱桢燕, 薛聪. 老年患者双腔起搏器术后心房高频事件的发生率及其危险因素分析[J]. 实用老年医学, 2026, 40(7): 720-724.

WANG Mengfei, XU Wei, ZHAO Rong, QIAN Bo, ZHU Zhenyan, XUE Cong. Analysis of the incidence and risk factors of atrial high-rate episodes after dual-chamber pacemaker implantation in elderly patients[J]. Practical Geriatrics, 2026, 40(7): 720-724.

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