Kerr C R, Mason M A
Pacing Clin Electrophysiol. 1985 May;8(3 Pt 1):348-55. doi: 10.1111/j.1540-8159.1985.tb05769.x.
The onset of atrial flutter or fibrillation in a patient with a DDD pacemaker may result in sensing of the atrial arrhythmia and an inappropriate ventricular pacing response. In order to assess the potential of this problem, we evaluated the amplitude of atrial electrograms recorded from the right atrial appendage during sinus rhythm and during atrial flutter or fibrillation during 19 episodes in 18 patients. In 11 episodes of fibrillation and eight episodes of flutter, there was no difference in amplitude of either unipolar or bipolar atrial electrograms compared to that recorded during sinus rhythm (p greater than 0.05). In 14 of 19 episodes, the direction of depolarization of the bipolar electrogram did not change appreciably between sinus rhythm and the atrial arrhythmia. In summary, there is insufficient difference between amplitude of atrial depolarizations recorded during sinus rhythm and atrial flutter or fibrillation to be differentiated reliably by DDD pacemakers.
植入DDD起搏器的患者发生心房扑动或颤动时，可能会感知到房性心律失常，并产生不适当的心室起搏反应。为了评估这一问题的可能性，我们对18例患者的19次发作进行了研究，分别记录了窦性心律期间以及心房扑动或颤动期间右心耳记录的心房电图振幅。在11次颤动发作和8次扑动发作中，单极或双极心房电图的振幅与窦性心律期间记录的相比无差异（p>0.05）。在19次发作中的14次，窦性心律和房性心律失常期间双极电图的去极化方向没有明显变化。总之，窦性心律期间与心房扑动或颤动期间记录的心房去极化振幅差异不足以被DDD起搏器可靠地区分。
