Abernathy W S, Lepeschkin E
Am Heart J. 1978 Apr;95(4):502-10. doi: 10.1016/0002-8703(78)90243-0.
Atrial activity can influence the ability of a failing artificial pacemaker to excite the heart. An appropriately timed atrial beat may cause failure in excitation by pacemaker stimuli which are usually successful in ventricular capture. Conversely, stimuli which usually fail in excitation may be made to succeed by an appropriately timed atrial beat. Two case reports and a review of the literature are presented. Alternative mechanisms for this influence of atrial activity are electrotonic effects (Wedensky facilitation or inhibition) and mechanical effects (motion of the pacing catheter or ventricular myocardium). The authors consider the latter mechanism preferable.
心房活动会影响功能衰竭的人工起搏器刺激心脏的能力。适时出现的心房搏动可能导致起搏器刺激引发兴奋失败，而这些刺激通常能成功夺获心室。相反，通常无法引发兴奋的刺激可能会因适时出现的心房搏动而成功。本文呈现了两例病例报告并对相关文献进行了综述。心房活动产生这种影响的其他机制包括电紧张效应（韦登斯基易化或抑制）和机械效应（起搏导管或心室心肌的运动）。作者认为后一种机制更具可能性。
