Imai K, Sueda T, Orihashi K, Ishii O, Matsuura Y
First Department of Surgery, School of Medicine, Hiroshima University, Japan.
Hiroshima J Med Sci. 2001 Mar;50(1):27-35.
Several authors have suggested that periodic activation is related to maintenance of atrial fibrillation (AF). The aim of this study was to examine periodic electrical activations in both atria that may lead to the generation and maintenance of AF associated with valvular diseases by means of fast Fourier transform (FFT) analysis. Atrial electrograms (AEGs) were analyzed in 15 persistent AF patients, who underwent pulmonary vein orifice (PVO) isolation with mitral valve surgery. Intraoperatively, AEGs of 4 seconds duration were acquired at 48 epicardial sites, 24 each from the right and left atrium (RA, LA). Dominant peaks (DPs) examined using FFT were present in 26% of all sampling points (380/1440). Prominent clustering of DPs was mostly observed on the LA. The mean AF cycle length (mAFCL) estimated from DP frequency was significantly shorter in LA than that in RA (178 +/- 32 msec vs 247 +/- 58, p = 0.0003). The shortest AF cycle length in each patient was mainly found in the LA. The PVO isolation procedures successfully eliminated AF in 87% of patients (13/15). In cases of recurred AF (2/15), the difference in mAFCL between bilateral atria was significantly smaller than in the case of successful AF elimination (17 +/- 7 msec vs 76 +/- 56, p = 0.042). FFT analysis of intraoperative mapping data clarified that periodic activity was present predominantly in LA. It may be possible to predict the efficacy of surgical procedures for eliminating AF using this technique.
几位作者提出，周期性激活与心房颤动（AF）的维持有关。本研究的目的是通过快速傅里叶变换（FFT）分析，检查双心房中的周期性电激活，这些激活可能导致与瓣膜疾病相关的AF的发生和维持。对15例持续性AF患者的心房电图（AEG）进行了分析，这些患者接受了肺静脉口（PVO）隔离术和二尖瓣手术。术中，在48个心外膜部位采集了持续4秒的AEG，右心房（RA）和左心房（LA）各24个。使用FFT检查的主导峰（DP）出现在所有采样点的26%（380/1440）。DP的显著聚集主要在LA上观察到。根据DP频率估计的平均AF周期长度（mAFCL）在LA中明显短于RA（178±32毫秒对247±58，p = 0.0003）。每位患者最短的AF周期长度主要在LA中发现。PVO隔离程序成功消除了87%患者（13/15）的AF。在AF复发的病例（2/15）中，双侧心房之间的mAFCL差异明显小于AF成功消除的病例（17±7毫秒对76±56，p = 0.042）。术中标测数据的FFT分析表明，周期性活动主要存在于LA中。使用该技术可能预测消除AF的外科手术疗效。
