Fujimura O, Kuo C S, Smith B A
Department of Medicine, University of Kentucky Medical Center, Lexington 40536-0084.
J Am Coll Cardiol. 1991 Dec;18(7):1722-6. doi: 10.1016/0735-1097(91)90510-g.
The ventricular rate and percent of pre-excited QRS complexes during atrial fibrillation were compared in two groups of patients with the Wolff-Parkinson-White syndrome. Group A consisted of 22 patients whose anterograde effective refractory period of the accessory pathway was longer than that of the atrioventricular (AV) node. Group B consisted of 23 patients in whom this relation was reversed. No patient had organic heart disease. Both groups had a similar effective refractory period of the accessory pathway (288 +/- 37 vs. 280 +/- 26 ms), whereas that of the AV node was shorter in group A than group B (242 +/- 25 vs. 285 +/- 27 ms, p = 0.0001). Patients in group A had a lower percent of pre-excited QRS complexes during atrial fibrillation (39 +/- 43% vs. 93 +/- 20%, p = 0.0001). In the 21 patients whose refractory period was measured, the difference was plotted against the percent of pre-excited QRS complexes; there was a significant correlation between the two (r = -0.83, p less than 0.001). In patients in whom pre-excited RR intervals were present, the pre-excited RR intervals were compared between the two groups. Both groups had similar effective refractory periods of the accessory pathway (265 +/- 22 vs. 280 +/- 27 ms) and ventricle (200 +/- 17 vs. 211 +/- 26 ms). The effective refractory period of the AV node was shorter in group A (248 +/- 22 vs. 285 +/- 28 ms, p = 0.0005). The shortest pre-excited RR interval did not show any difference (244 +/- 37 vs. 265 +/- 41 ms). However, both the average (328 +/- 39 vs. 397 +/- 56 ms, p = 0.001) and longest (495 +/- 109 vs. 666 +/- 205 ms, p = 0.02) pre-excited RR intervals were shorter in group A.(ABSTRACT TRUNCATED AT 250 WORDS)
在两组预激综合征患者中比较了房颤时的心室率和预激QRS波群的百分比。A组由22例患者组成，其旁路的前传有效不应期长于房室（AV）结。B组由23例患者组成，两者关系相反。所有患者均无器质性心脏病。两组旁路的有效不应期相似（288±37 vs. 280±26毫秒），而A组AV结的有效不应期短于B组（242±25 vs. 285±27毫秒，p = 0.0001）。A组患者房颤时预激QRS波群的百分比更低（39±43% vs. 93±20%，p = 0.0001）。在测量了不应期的21例患者中，将差值与预激QRS波群的百分比进行了绘图；两者之间存在显著相关性（r = -0.83，p < 0.001）。在存在预激RR间期的患者中，比较了两组的预激RR间期。两组旁路的有效不应期相似（265±22 vs. 280±27毫秒），心室的有效不应期也相似（200±17 vs. 211±26毫秒）。A组AV结的有效不应期较短（248±22 vs. 285±28毫秒，p = 0.0005）。最短的预激RR间期无差异（244±37 vs. 265±41毫秒）。然而，A组的平均（328±39 vs. 397±56毫秒，p = 0.001）和最长（495±109 vs. 666±205毫秒，p = 0.02）预激RR间期均较短。（摘要截短于250字）
