关键词: 心房颤动, 左心室顺应性, 心脏植入式装置

Abstract: Objective  To explore the association of left ventricular compliance assessed by diastolic wall strain (DWS) with new atrial high-rate episodes (AHREs) after the implantation of cardiac implantable electronic devices(CIEDs). 
Methods  The medical records of 201 patients with CIEDs implanted in the First Hospital of Hebei Medical University were collected retrospectively. The patients were followed up for more than 2 years. They were divided into AHREs group and non-AHREs group according to occurrence of AHREs. The preoperative DWS and general data of the two groups were compared, and the independent risk factors of AHREs after operation were analyzed by multivariate COX stepwise regression analysis. 
Results  Of all patients, 26 had AHREs within 12 months after implantation, and a total of 64 patients had AHREs within 2 years after implantation. During the follow-up period, the AHREs group and the non-AHREs group were compared, and there were significant differences in left atrial anteroposterior diameter, left atrial transverse diameter and DWS (P＜0.05). Multivariate COX stepwise regression analysis showed that the increase of left atrial transverse diameter and the decrease of DWS were independent risk factors for AHREs in patients after CIEDS (P＜0.05). ROC curve showed that the optimal critical value of DWS was 0.35, the sensitivity was 81%, and the specificity was 82%. Compared with the group with DWS ≥ 0.35, the group with DWS<0.35 had an increased risk of AHREs (P＜0.05).
Conclusion  As an echocardiographic marker reflecting left ventricular diastolic function, reduced DWS values increase the risk of new AHREs after CIEDS implantation. 

Key words: atrial fibrillation, left ventricle compliance, cardiac implantable electronic devices