Weber Stefan, Ndrepepa Gjin, Schneider Michael, Deisenhofer Isabel, Zrenner Bernhard, Schmitt Claus
Klinik und Poliklinik für Innere Medizin II, Universität Regensburg, Germany.
Pacing Clin Electrophysiol. 2007 Mar;30(3):295-303. doi: 10.1111/j.1540-8159.2007.00669.x.
Information about the spatiotemporal organization of atrial activity at the onset of atrial fibrillation (AF) is still limited.
AF mapping was performed in 30 patients with AF (mean age 53 +/- 9 years, 26 males) by deploying a noncontact mapping balloon in the left atrium (LA). Twenty-four patients had paroxysmal AF and six patients had persistent AF. Three types of AF episodes were analyzed: nonsustained AF (lasting <or= 30 seconds), sustained AF (lasting > 30 seconds, with spontaneous conversion or requiring internal cardioversion and subsequent stable sinus rhythm), and persistent AF episodes (stable sinus rhythm lasting <or= 1 minute after cardioversion).
A total of 101 spontaneous AF onset episodes were analyzed. Analysis of AF onset showed that there was a progressive shortening of the initial cycle lengths from nonsustained episodes to sustained episodes and to persistent AF episodes. There was an earlier and more rapid reduction in the cycle lengths from persistent episodes to sustained episodes and to nonsustained episodes of AF (P < 0.05 for persistent vs sustained and for sustained vs nonsustained episodes). The development of multiwavelet activity and disorganization of conduction occurred earlier in persistent and sustained episodes than in nonsustained AF episodes. LA size was greater in patients with persistent AF episodes compared with patients with sustained or nonsustained AF episodes.
Electrophysiological events that develop at the onset of AF seem to be different in different types of AF. A more rapid degeneration into the fibrillatory activity was observed in persistent and sustained AF than in nonsustained AF episodes.
关于房颤（AF）发作时心房活动的时空组织信息仍然有限。
通过在左心房（LA）部署非接触式标测球囊，对30例房颤患者（平均年龄53±9岁，26例男性）进行房颤标测。24例患者为阵发性房颤，6例患者为持续性房颤。分析了三种类型的房颤发作：非持续性房颤（持续时间≤30秒）、持续性房颤（持续时间>30秒，有自发转复或需要体内电复律并随后维持稳定窦性心律）以及持续性房颤发作（电复律后窦性心律稳定持续时间≤1分钟）。
共分析了101次自发房颤发作。房颤发作分析显示，从非持续性发作到持续性发作再到持续性房颤发作，初始周期长度逐渐缩短。从持续性发作到持续性房颤发作再到非持续性房颤发作，周期长度的缩短更早且更快（持续性与持续性房颤发作以及持续性房颤发作与非持续性发作相比，P<0.05）。多小波活动的发展和传导紊乱在持续性和持续性房颤发作中比在非持续性房颤发作中出现得更早。与持续性或非持续性房颤发作的患者相比，持续性房颤发作患者的左心房尺寸更大。
房颤发作时发生的电生理事件在不同类型的房颤中似乎有所不同。与非持续性房颤发作相比，持续性和持续性房颤发作中观察到更快地退化为颤动活动。
