Heida Annejet, van Schie Mathijs S, van der Does Willemijn F B, Taverne Yannick J H J, Bogers Ad J J C, de Groot Natasja M S
Erasmus Medical Center, Department of Cardiology, 3015 GD Rotterdam, The Netherlands.
Erasmus Medical Center, Department of Cardiothoracic Surgery, 3015 GD Rotterdam, The Netherlands.
J Clin Med. 2021 Jun 14;10(12):2614. doi: 10.3390/jcm10122614.
It is unknown to what extent atrial fibrillation (AF) episodes affect intra-atrial conduction velocity (CV) and whether regional differences in local CV heterogeneities exist during sinus rhythm. This case-control study aims to compare CV assessed throughout both atria between patients with and without AF. Patients ( = 34) underwent intra-operative epicardial mapping of the right atrium (RA), Bachmann's bundle (BB), left atrium (LA) and pulmonary vein area (PVA). CV vectors were constructed to calculate median CV in addition to total activation times (TAT) and unipolar voltages. Biatrial median CV did not differ between patients with and without AF (90 ± 8 cm/s vs. 92 ± 6 cm/s, = 0.56); only BB showed a CV reduction in the AF group (79 ± 12 cm/s vs. 88 ± 11 cm/s, = 0.02). In patients without AF, there was no predilection site for the lowest CV (P) (RA: 12%; BB: 29%; LA: 29%; PVA: 29%). In patients with AF, lowest CV was most often measured at BB (53%) and ranged between 15 to 22 cm/s (median: 20 cm/s). Lowest CVs were also measured at the LA (18%) and PVA (29%), but not at the RA. AF was associated with a prolonged TAT ( = 0.03) and decreased voltages (P) at BB ( = 0.02). BB was a predilection site for slowing of conduction in patients with AF. Prolonged TAT and decreased voltages were also found at this site. The next step will be to determine the relevance of a reduced CV at BB in relation to AF development and maintenance.
目前尚不清楚房颤（AF）发作在多大程度上影响心房内传导速度（CV），以及在窦性心律期间局部CV异质性是否存在区域差异。本病例对照研究旨在比较有AF和无AF患者整个心房的CV。34例患者接受了术中右心房（RA）、巴赫曼束（BB）、左心房（LA）和肺静脉区域（PVA）的心外膜标测。构建CV向量以计算中位数CV以及总激活时间（TAT）和单极电压。有AF和无AF患者的双房中位数CV无差异（90±8cm/s对92±6cm/s，P = 0.56）；仅BB在AF组中显示CV降低（79±12cm/s对88±11cm/s，P = 0.02）。在无AF的患者中，最低CV（P）没有偏好部位（RA：12%；BB：29%；LA：29%；PVA：29%）。在有AF的患者中，最低CV最常出现在BB（53%），范围在15至22cm/s之间（中位数：20cm/s）。最低CV也出现在LA（18%）和PVA（29%），但未出现在RA。AF与TAT延长（P = 0.03）和BB处电压降低（P）相关（P = 0.02）。BB是AF患者传导减慢的偏好部位。在该部位也发现了TAT延长和电压降低。下一步将确定BB处CV降低与AF发生和维持的相关性。
