Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showaku, Nagoya 466-8550, Japan.
Europace. 2010 Jan;12(1):124-9. doi: 10.1093/europace/eup372.
Identification of arrhythmogenic pulmonary veins (PVs) initiating atrial fibrillation is helpful for catheter ablation. The aim of this study was to examine the possibility to recognize the arrhythmogenic PV using Holter ECG.
In 20 patients, P-wave characteristics were studied during pacing from four PVs. Holter ECG was recorded using two leads: the modified CC5 (Lead 1) and NASA (Lead 2), and the P-wave amplitude and duration were evaluated. In Lead 1, P-waves produced by left PV pacing were significantly lower in amplitude than right PV pacing (-3 +/- 75 vs. 86 +/- 43 microV, P < 0.001). In Lead 2, pacing in superior PVs produced P-waves with higher amplitude than inferior PVs (210 +/- 74 vs. 125 +/- 66 muV, P < 0.001). The criteria proposed by the morphological characteristics of P-waves identified putative arrhythmogenic PVs with an accuracy of 78%.
It might be possible to identify putative arrhythmogenic PVs by modified Holter ECG recording.
识别引发心房颤动的致心律失常肺静脉（PVs）有助于导管消融。本研究旨在探讨使用动态心电图识别致心律失常 PV 的可能性。
在 20 例患者中，研究了从四个 PV 起搏时的 P 波特征。使用两个导联（改良 CC5 [导联 1]和 NASA [导联 2]）记录动态心电图，并评估 P 波幅度和持续时间。在导联 1 中，左 PV 起搏产生的 P 波幅度明显低于右 PV 起搏（-3 +/- 75 与 86 +/- 43 μV，P < 0.001）。在导联 2 中，上腔 PV 起搏产生的 P 波幅度高于下腔 PV 起搏（210 +/- 74 与 125 +/- 66 μV，P < 0.001）。根据 P 波形态特征提出的标准，准确识别出了 78%的潜在致心律失常 PV。
通过改良的动态心电图记录可能可以识别潜在的致心律失常 PV。
