Holt N D, Hetherington K, Brady S, Dark J H, McComb J M
Regional Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, UK.
Europace. 1999 Jul;1(3):187-91. doi: 10.1053/eupc.1999.0037.
The recipient atrial remnant has been used as a control in studies ofchronotropic response following orthotopic cardiac transplantation and as a trigger for the donor heart. It is not known, however, whether its function is normal. We investigated the electrophysiological properties of the recipient atrial remnant.
Fifty patients were studied, mean age 49 years (range 20-63) and mean time post-orthotopic cardiac transplantation of 31 months (range 1-107). Recipient atrial rhythm, spontaneous cycle length and sinus node function were determined. Atrial fibrillation/flutter was identified in 10/50 (20%). Of those in sinus rhythm, significant bradycardia was present in 12/40 (30%). The mean spontaneous cycle length was 929+/-188 ms. Three patients demonstrated variable atrial electrocardiogram morphology and a further three patients had marked variations in resting cycle length. The sinus node function was abnormal in 2/34 (6%).
Only 56% recipient atria had normal sinus rhythm, with 21% of these demonstrating features consistent with a wandering atrial pacemaker. The recipient atrial remnant is not normal in the majority of transplant recipients and should be used with caution in studies involving its use as a control or as a trigger for the donor heart.
在原位心脏移植后的变时性反应研究中，受者心房残余部分被用作对照，并作为供体心脏的触发因素。然而，其功能是否正常尚不清楚。我们研究了受者心房残余部分的电生理特性。
对50例患者进行了研究，平均年龄49岁（范围20 - 63岁），原位心脏移植后平均时间为31个月（范围1 - 107个月）。测定了受者心房节律、自发周期长度和窦房结功能。50例中有10例（20%）发现心房颤动/扑动。在窦性心律的患者中，40例中有12例（30%）存在显著心动过缓。平均自发周期长度为929±188毫秒。3例患者表现出可变的心房心电图形态，另外3例患者静息周期长度有明显变化。34例中有2例（6%）窦房结功能异常。
仅56%的受者心房有正常窦性心律，其中21%表现出与游走性心房起搏点一致的特征。在大多数移植受者中，受者心房残余部分不正常，在将其用作对照或供体心脏触发因素的研究中应谨慎使用。
