Campbell R M, Dick M, Crowley D C, Rocchini A P, Snider A R, Rosenthal A
Department of Pediatrics, University of Michigan, Ann Arbor.
Pediatr Cardiol. 1988;9(2):85-9. doi: 10.1007/BF02083705.
No data exist concerning the total sinoatrial conduction time (TSACT) in children that compare values determined by the atrial extrastimulation technique (TSACTS) with those generated by the atrial pacing method (TSACTN). In this study, TSACT in 55 patients, age 0.2-18.5, was measured using both techniques. TSACTN was performed at a mean 90% (TSACTN-90) (n = 32) or a mean 95% (TSACTN-95 and (n = 38) of sinus cycle length (SCL). When data generated during determination of TSACTN-90 and TSACTS were compared, SCL and recovery cycle length (REC) were similar for both techniques. Likewise, TSACTS (128 +/- 40 ms) and TSACTN-90 (126 +/- 74 ms) were not significantly different. Coefficient of correlation was r = 0.82, p less than 0.001. Chi-square analysis demonstrated a strong association of normal and abnormal values between TSACTS and TSACTN-90. In contrast, when values generated during TSACTN-95 and TSACTS were compared, TSACTS exceeded TSACTN-95 (137 +/- 38 vs 105 +/- 58 ms; p less than 0.001). Values for SCL and REC were similar while correlation between TSACT determined by the two techniques remained strong (r = 0.82, p less than 0.001). Despite a good correlation between TSACTN-90 and TSACTS, individual differences in magnitude and direction were noted between the two techniques. In summary, TSACTN-90 approximates TSACTS in children. TSACTN-90 is preferable to TSACTN-95, probably due to more complete sinus node capture during atrial pacing. However, the behavior of the sinus node in response to extrastimuli (single or train) precludes favoring one technique over the other. More precise evaluation of sinoatrial conduction will require direct recording of sinus node activity.
目前尚无关于儿童总窦房传导时间（TSACT）的数据，这些数据能够比较通过心房额外刺激技术（TSACTS）测定的值与通过心房起搏方法（TSACTN）得出的值。在本研究中，使用这两种技术对55例年龄在0.2至18.5岁的患者的TSACT进行了测量。TSACTN在平均窦性周期长度（SCL）的90%（TSACTN - 90）（n = 32）或平均95%（TSACTN - 95，n = 38）时进行。当比较TSACTN - 90和TSACTS测定过程中产生的数据时，两种技术的SCL和恢复周期长度（REC）相似。同样，TSACTS（128±40毫秒）和TSACTN - 90（126±74毫秒）无显著差异。相关系数r = 0.82，p小于0.001。卡方分析表明TSACTS和TSACTN - 90之间正常和异常值存在强关联。相比之下，当比较TSACTN - 95和TSACTS测定过程中产生的值时，TSACTS超过TSACTN - 95（137±38对105±58毫秒；p小于0.001）。SCL和REC的值相似，而两种技术测定的TSACT之间的相关性仍然很强（r = 0.82，p小于0.001）。尽管TSACTN - 90和TSACTS之间存在良好的相关性，但两种技术在大小和方向上存在个体差异。总之，TSACTN - 90在儿童中接近TSACTS。TSACTN - 90比TSACTN - 95更可取，可能是因为心房起搏期间窦房结捕获更完整。然而，窦房结对额外刺激（单个或串刺激）的反应行为使得无法偏袒一种技术优于另一种技术。对窦房传导进行更精确的评估将需要直接记录窦房结活动。
