Lee S H, Lin F Y, Yu W C, Cheng J J, Kuan P, Hung C R, Chang M S, Chen S A
Institute of Clinical Medicine of National Yang-Ming University, Veterans General Hospital-Taipei, Shin-Kong Memorial Hospital, and National Taiwan University, Taipei, Taiwan.
Circulation. 1999 Mar 9;99(9):1255-64. doi: 10.1161/01.cir.99.9.1255.
Regional differences in recovery of tachycardia-induced changes of atrial electrophysiological properties have not been well studied.
In the control group (5 dogs), atrial effective refractory period (AERP) and inducibility of atrial fibrillation (AF) were assessed before and every 4 hours for 48 hours after complete atrioventricular junction (AVJ) ablation with 8-week VVI pacing. In experimental group 1 (15 dogs), AERP and inducibility of AF were assessed before and after complete AVJ ablation with 8-week rapid right atrial (RA) pacing (780 bpm) and VVI pacing. In experimental group 2 (7 dogs), AERP and inducibility of AF were assessed before and after 8-week rapid left atrial (LA) pacing and VVI pacing. AERP and inducibility and duration of AF were obtained from 7 epicardial sites. In the control group, atrial electrophysiological properties obtained immediately and during 48-hour measurements after pacing did not show any change. In the 2 experimental groups, recovery of atrial electrophysiological properties included a progressive recovery of AERP shortening, recovery of AERP maladaptation, and decrease of duration and episodes of reinduced AF. However, recovery of shortening and maladaptation of AERP and inducibility of AF was slower at the LA than at the RA and Bachmann's bundle.
The LA had a slower recovery of tachycardia-induced changes of atrial electrophysiological properties, and this might play a critical role in initiation of AF.
心动过速引起的心房电生理特性变化的恢复存在区域差异，这方面尚未得到充分研究。
在对照组（5只犬）中，在完全房室交界（AVJ）消融并进行8周VVI起搏后，于起搏前及之后每4小时评估一次心房有效不应期（AERP）和房颤（AF）的诱发率，持续48小时。在实验组1（15只犬）中，在完全AVJ消融并进行8周快速右心房（RA）起搏（780次/分钟）和VVI起搏前后评估AERP和AF的诱发率。在实验组2（7只犬）中，在8周快速左心房（LA）起搏和VVI起搏前后评估AERP和AF的诱发率。从7个心外膜部位获取AERP、AF的诱发率和持续时间。在对照组中，起搏后立即及48小时测量期间获得的心房电生理特性未显示任何变化。在2个实验组中，心房电生理特性的恢复包括AERP缩短的逐渐恢复、AERP适应不良的恢复以及再次诱发AF的持续时间和发作次数的减少。然而，LA处AERP缩短和适应不良的恢复以及AF的诱发率恢复比RA和巴赫曼束处更慢。
LA处心动过速引起的心房电生理特性变化的恢复较慢，这可能在AF的起始中起关键作用。
