Cinca J, Moya A, Bardají A, Figueras J, Rius J
Am Heart J. 1987 Aug;114(2):327-33. doi: 10.1016/0002-8703(87)90499-6.
Sequential bedside electrophysiologic testing was performed over 22 hours at intervals of 1 to 2 hours in 13 patients with left-sided Kent bundles to assess possible daily variations in the capacity to electrically induce reciprocating tachycardia. In all patients the tachycardia involved the accessory pathway in retrograde atrial activation. Between midnight and early morning the more relevant findings with respect to the first testing performed at midday were a significant prolongation of the effective refractory period of the atrial (from 212 +/- 22 msec to 229 +/- 22 msec; p less than 0.01), atrioventricular node (from 235 +/- 22 msec to 285 +/- 15 msec; p less than 0.005), right ventricle (from 209 +/- 15 msec to 221 +/- 12 msec; p less than 0.001), and retrograde Kent bundle (from 278 +/- 34 msec to 294 +/- 24 msec; p less than 0.01) and a reduction of the inducibility of tachycardia from both the coronary sinus from 90% to 50%; p less than 0.001) and the right ventricle from 80% to 15%; p less than 0.001). Thus our results indicate that there exists a nocturnal protection against electrical induction of reciprocating tachycardia that is associated with a prolongation of the atrial, atrioventricular nodal, ventricular, and Kent bundle refractoriness.
对13例左侧肯特束患者每隔1至2小时进行22小时的连续床边电生理测试，以评估电诱发折返性心动过速能力的每日变化可能性。所有患者的心动过速均涉及逆行心房激动时的旁路。与中午进行的首次测试相比，午夜至清晨更相关的发现是心房有效不应期显著延长（从212±22毫秒延长至229±22毫秒；p<0.01）、房室结（从235±22毫秒延长至285±15毫秒；p<0.005）、右心室（从209±15毫秒延长至221±12毫秒；p<0.001）以及逆行肯特束（从278±34毫秒延长至294±24毫秒；p<0.01），并且从冠状窦诱发心动过速的诱导率从90%降至50%（p<0.001），从右心室诱发心动过速的诱导率从80%降至15%（p<0.001）。因此，我们的结果表明，夜间存在对电诱发折返性心动过速的保护作用，这与心房、房室结、心室和肯特束不应期的延长有关。
