Meijler F L, Jalife J
Hart-Long Instituut, Academisch Ziekenhuis, Universiteit Utrecht.
Ned Tijdschr Geneeskd. 1999 Jun 12;143(24):1252-6.
An atrial impulse that is not conducted to the ventricle may slow down the conduction of the next atrial impulse. A ventricular extrasystole may also affect the conduction through the AV node. This phenomenon is called 'concealed conduction'. At least three mechanisms are possible to explain concealed conduction, but neither weakening of the impulse as the conduction proceeds nor electrotonic modulation of the pacemaker function of the AV node is in accordance with the observed constant irregularity of atrial fibrillation. The most probable mechanism to explain the ventricular rhythm during atrial fibrillation is the electrotonic change (inhibition) by atrial impulses of the conduction properties of the AV node.
未传导至心室的心房冲动可能会减慢下一个心房冲动的传导。室性期前收缩也可能影响通过房室结的传导。这种现象称为“隐匿性传导”。至少有三种机制可以解释隐匿性传导,但随着传导进行冲动减弱以及房室结起搏功能的电紧张调节均与观察到的房颤持续不规则性不符。解释房颤时心室节律最可能的机制是心房冲动对房室结传导特性的电紧张性改变(抑制)。