孤立性阵发性心房颤动中局灶性房间隔后传导延迟的进一步证据。

Further evidence of localized posterior interatrial conduction delay in lone paroxysmal atrial fibrillation.

作者信息

Platonov P G, Yuan S, Hertervig E, Kongstad O, Roijer A, Vygovsky A B, Chireikin L V, Olsson S B

机构信息

Arrhythmia Research Laboratory, Research Institute of Cardiology, St Petersburg, Russia.

出版信息

Europace. 2001 Apr;3(2):100-7. doi: 10.1053/eupc.2001.0150.

DOI:10.1053/eupc.2001.0150

PMID:11333046

Abstract

AIMS

Prolongation of interatrial conduction time has been reported in patients with paroxysmal atrial fibrillation (PAF). The study objective was to localize the region of the conduction delay in patients with lone PAF.

METHODS AND RESULTS

Twenty-one patients with lone PAF and 23 patients with AV nodal re-entrant tachycardia ablation without history of PAF (control group) were recruited. Endocardial recordings were made during sinus rhythm and programmed atrial stimulation. The authors measured the interatrial conduction time, the 'right-sided' conduction time between the high lateral right atrium and the proximal coronary sinus (RA-CSp), and the 'left-sided' conduction time between the proximal and the distal coronary sinus (CSp-LA). During sinus rhythm, the interatrial conduction time was longer in the PAF group (103 +/- 19 vs 86 +/- 12 ms, P<0.01) due to delay of right-sided conduction (RA-CSp was 74 +/- 20 vs 56 +/- 10 ms, P<0.01). During programmed stimulation at the distal coronary sinus, the maximal RA-CSp time was also longer in the PAF group (110 +/- 47 vs 69 +/- 16 ms, P<0.05). No differences in CSp-LA time were observed.

CONCLUSION

This study supports the role of posterior septal right atrial conduction disturbances in the genesis of lone PAF.

摘要

目的

阵发性心房颤动（PAF）患者中曾有关于心房传导时间延长的报道。本研究的目的是定位孤立性PAF患者传导延迟的区域。

方法与结果

招募了21例孤立性PAF患者和23例无PAF病史的房室结折返性心动过速消融患者（对照组）。在窦性心律和程控心房刺激期间进行心内膜记录。作者测量了心房传导时间、高位右侧心房与近端冠状窦之间的“右侧”传导时间（RA-CSp）以及近端与远端冠状窦之间的“左侧”传导时间（CSp-LA）。在窦性心律时，PAF组的心房传导时间较长（103±19 vs 86±12毫秒，P<0.01），原因是右侧传导延迟（RA-CSp为74±20 vs 56±10毫秒，P<0.01）。在远端冠状窦进行程控刺激时，PAF组的最大RA-CSp时间也较长（110±47 vs 69±16毫秒，P<0.05）。未观察到CSp-LA时间有差异。