Pathogeny And Correlative Factors Of Atrial Premature Beats And Atrial Tachycardia

Objective：To explore risk factors, effects on cardiac structure andfunction, corresponding treatment methods and curative effect of APBs andAT.Methods：This is a case-control study. Check electrocardiogram reportof the patient hospitalized and found mainly APBs and AT by holter in theFirst Affiliated Hospital of Chongqing Medical University during2011Julyto2012June. Analyze main causes of APBs and AT through calculatingProportion of main diseases of APBs and AT; Analyze risk factors of APBsand AT through comparing difference of APBs frequency among differentsex, hypertension, CHD, diabetes, smoking, drinking, BP, FBS, electrolytes,thyroid function, blood lipids，age and atrial enlargement; Analyze riskfactors of FAPBs through comparing different constituent ratio of sex,hypertension, CHD, diabetes, smoking, drinking, BP, FBS, electrolytes,thyroid function, blood lipids, age, atrial enlargement between FAPBs andSAPBs; Analyze risk factors of AT through comparing different constituentratio of age, hypertension, CHD, atrial enlargement, ST/T change, cardiac function, EF value between APBs and AT; Analyze whether APBs and ATare harm to human body through comparing difference of APBs frequencyamong different related symptoms, frequency of long pause after APBs,ST/T change, HR，LVEF and cardiac function; Analyze whether FAPBs ismore serious harm to human body through comparing different constituentratio of related symptoms, frequency of R-R long pause after APBs, ST/Tchange, HR,LVEF, cardiac function, atrioventricular block between FAPBsand SAPBs; Analyze effect of beta blockers and other treatment throughcomparing difference between FAPBs and SAPBs.Results：1.Main causes of APBs and AT are CHD, HHD, hypertension,cancer, chronic inflammation, hyokalemia, thyroid diseases, valvular heartdiseases, dilated cardiomyopathy, PHD and acute inflammation. The topthree causes are respectively accounted for20.08%,19.87%and16.95%;2.There’s no significantly difference of APBs frequency among differentgender, hypertension, CHD, diabetes, smoking, drinking, BP, FBS,electrolytes, blood lipids, thyroid function, change of cardiac structure, ageand atrial enlargement;3. Patients with FAPBs accounted for48.12%, arerelated to age, history of hypertension, and valvular heart disease;4. Patientswith APBs and AT accounted for87.24%, are positively correlated with age,history of hypertension and atrial enlargement;5. FAPBs cause faster HRand ST/T change, leading to myocardial ischemia and heart failure (4.16±8.54b/min, t=3.62, P=0.0003);6. Frequency of R-R long pause after APBs may be correlated to the symptom (181.6±922.57/24h, t=2.37, P <0.05);7.Patients with R-R>1.5s are accounted for47.49%, and the frequency of R-Rlong pause after APBs is224.48±947.49/24h. Among them, symptomaticpatients are accounted for53.54%. The long R-R interval after APBs occursduring21:01-06:00in the stage of sleep accounted for77.14%, and occursduring06:01-21:00in awakening period accounted for22.86%;8. Patientswithout symptoms are accounted for59.41%;9. After the treatment,remission rate of symptomatic APBs and AT patients is87.11%;10. Betablockers can effective relieve the patient’s heart palpitations, chest tightness,dizziness, fatigue and other symptoms (t=32.5519, P<0.0001).Patientsshouldn’t use beta blockers accounted for46.86%. The use of beta blockerson patients with indication and without contraindication is only17.75%；11.Only1patient had recurrent focal AT cured by radiofrequency ablation,accounted for0.21%.Conclusions：1.The main causes of FAPBs and AT are organic heartdiseases, such as CHD, HHD and hypertension, and may be related toincreasing age, history of hypertension, valvular heart disease and atrialenlargement;2.FAPBs and AT can lead to faster HR, heart failure,myocardial and peripheral organs ischemia, with heart palpitations, chesttightness, dizziness and weakness; There are more asymptomatic APBs andAT patients, and frequency of R-R long pause after APBs may beassociated with symptoms;3. Correcting causes and treating the primary diseases can relieve87.11%of APBs and AT patients; Beta blockers areeffective, but the use rate of beta blockers in patients with indication andwithout contraindication is only17.75%;4. Focal AT may be cured byradiofrequency ablation. Multifocal APBs and AT are more common, but itsablation success rate is low, in the treatment of primary disease.