Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
Translational Cardiothoracic Surgery Research Lab, Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
Ann Med. 2023 Dec;55(1):1431-1441. doi: 10.1080/07853890.2023.2193426.
It is unknown which features of unipolar atrial electrogram (U-AEGM) morphology are affected by ageing and whether age-related changes in U-AEGM morphology are equally distributed throughout the right and left atria.
Epicardial high-resolution mapping was performed in patients undergoing coronary artery bypass grafting surgery during sinus rhythm (SR). Mapping areas include the right atrium (RA), left atrium (LA), pulmonary vein area (PVA) and Bachmann's bundle (BB). Patients were categorized into a young (age < 60) and aged (age ≥ 60) group. U-AEGM were classified as single potentials (SPs, one deflection), short double potentials (SDPs, deflection interval ≤ 15ms), long double potentials (LDPs, deflection interval > 15ms) and fractionated potentials (FPs, ≥3 deflections).
A total of 213 patients (age: 67 (59-73) years; young group = 58, aged group = 155) were included. Only at BB, the proportion of SPs ( = 0.007) was significantly higher in the young group, while the proportion of SDPs ( = 0.051), LDPs ( = 0.004) and FPs ( = 0.006) was higher in the aged group. After adjusting for potential confounders, older age was associated with a reduction in SPs [regression coefficient (β): -6.33, 95% confident interval (CI): -10.37 to -2.30] at the expense of an increased proportion of SDPs (β: 2.49, 95% CI: 0.09 to 4.89), LDPs (β: 1.94, 95% CI: 0.21 to 3.68) and FPs (β: 1.90, 95% CI: 0.62 to 3.18).
Age-related remodeling particularly affects BB as indicated by the decreased amount of non-SP at this location in the elderly.Key MessagesAgeing preferentially affects the morphology of unipolar atrial electrograms recorded at Bachmann's bundle.At Bachmann's bundle, the proportion of short double-, long double- and fractionated potentials increase during ageing at the expense of a decrease in the proportion of single potentials, reflecting aggravation of abnormalities in conduction.The increase in abnormal unipolar atrial electrograms at Bachmann's bundle during ageing supports the concept that Bachmann's bundle may play an important role in development of age-related arrhythmias such as atrial fibrillation.
目前尚不清楚单极心房电图（U-AEGM）形态的哪些特征受年龄影响，以及 U-AEGM 形态的年龄相关性变化是否在左右心房均匀分布。
在窦性心律（SR）下接受冠状动脉旁路移植术的患者中进行心外膜高分辨率映射。映射区域包括右心房（RA）、左心房（LA）、肺静脉区域（PVA）和 Bachmann 束（BB）。患者分为年轻（年龄<60 岁）和老年（年龄≥60 岁）组。U-AEGM 分为单电位（SP，一个偏转）、短双电位（SDP，偏转间隔≤15ms）、长双电位（LDP，偏转间隔>15ms）和分化解剖电位（FP，≥3 个偏转）。
共纳入 213 例患者（年龄：67（59-73）岁；年轻组=58 例，老年组=155 例）。仅在 BB，年轻组 SP 的比例（=0.007）显著较高，而老年组 SDP（=0.051）、LDP（=0.004）和 FP（=0.006）的比例较高。在调整潜在混杂因素后，年龄较大与 SP 减少相关[回归系数（β）：-6.33，95%置信区间（CI）：-10.37 至-2.30]，而 SDP（β：2.49，95%CI：0.09 至 4.89）、LDP（β：1.94，95%CI：0.21 至 3.68）和 FP（β：1.90，95%CI：0.62 至 3.18）的比例增加。
年龄相关性重塑主要影响 BB，表现为老年人此处非 SP 数量减少。
关键信息
年龄相关的重塑主要影响 Bachmann 束记录的单极心房电图形态。
在 Bachmann 束，随着年龄的增长，短双极、长双极和分化解剖电位的比例增加，而单极电位的比例下降，反映出传导异常的加重。
随着年龄的增长，Bachmann 束的异常单极心房电图增加，支持 Bachmann 束在发展与年龄相关的心律失常（如心房颤动）中可能发挥重要作用的概念。
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