Unit Translational Electrophysiology, Department of Cardiology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
Department of Cardiothoracic surgery, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
J Cardiovasc Electrophysiol. 2021 Apr;32(4):903-912. doi: 10.1111/jce.14978. Epub 2021 Mar 10.
Advancing age is a known risk factor for developing atrial fibrillation (AF), yet it is unknown which electrophysiological changes contribute to this increased susceptibility. The goal of this study is to investigate conduction disturbances and unipolar voltages (UV) related to aging.
We included 216 patients (182 male, age: 36-83 years) without a history of AF undergoing elective coronary artery bypass surgery. Five seconds of sinus rhythm were recorded intraoperatively at the right atrium (RA), Bachmann's bundle (BB), the left atrium and the pulmonary vein area (PVA). Conduction delay (CD), -block (CB), -velocity (CV), length of longest CB lines and UV were assessed in all regions.
With aging, increasing conduction disturbances were found, particularly at RA and BB (RA: longest CB line r = .158, p = .021; BB: CB prevalence r = .206, p = .003; CV r = -.239, p < .0005). Prevalence of low UV areas (UV <5th percentile) increased with aging at the BB and PVA (BB: r = .237, p < .0005 and PVA: r = .228, p = .001).
Aging is accompanied by an increase in conduction disturbances during sinus rhythm and a higher prevalence of low UV areas, particularly at BB and in the RA. These electrophysiological alterations could in part explain the increasing susceptibility to AF development associated with aging.
随着年龄的增长，心房颤动（AF）的发病风险也随之增加，但目前尚不清楚哪些电生理变化导致了这种易感性的增加。本研究旨在探讨与年龄相关的传导障碍和单极电压（UV）。
我们纳入了 216 名（男 182 名，年龄 36-83 岁）无 AF 病史的择期行冠状动脉旁路移植术的患者。术中在右心房（RA）、Bachmann 束（BB）、左心房和肺静脉区域（PVA）记录 5 秒窦性心律。评估所有区域的传导延迟（CD）、-阻滞（CB）、-速度（CV）、最长 CB 线长度和 UV。
随着年龄的增长，发现传导障碍逐渐增加，尤其是在 RA 和 BB（RA：最长 CB 线 r = 0.158，p = 0.021；BB：CB 患病率 r = 0.206，p = 0.003；CV r = -0.239，p < 0.0005）。随着年龄的增长，BB 和 PVA 的低 UV 区（UV <5 百分位）的患病率也增加（BB：r = 0.237，p < 0.0005；PVA：r = 0.228，p = 0.001）。
窦性心律时，随着年龄的增长，传导障碍增加，低 UV 区（特别是 BB 和 RA）的患病率增加。这些电生理改变可能部分解释了与年龄相关的 AF 发展易感性增加的原因。
