Veen Danny, Ye Ziliang, van Schie Mathijs S, Knops Paul, Kavousi Maryam, Vos Lara, Yildirim Vehpi, Taverne Yannick J H J, de Groot Natasja M S
Dept. of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Dept. of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Int J Cardiol Heart Vasc. 2025 Jan 3;56:101597. doi: 10.1016/j.ijcha.2024.101597. eCollection 2025 Feb.
Areas of conduction disorders play an important role in both initiation and perpetuation of AF and can be recognized by specific changes in unipolar potential morphology. For example, EGM fractionation may be caused by asynchronous activation of adjacent cardiomyocytes because of structural barriers such as fibrotic strands. However, it is unknown whether there are sex differences in unipolar potential morphology. Therefore, atrial potential morphologies during sinus rhythm (SR) were compared between male and female patients.
Based on propensity score matching, 62 male and female patients in whom high-resolution mapping of the right atrium (RA), left atrium (LA), and pulmonary vein area (PVA) including Bachmann's bundle (BB) was performed during coronary bypass grafting surgery and/or valvular heart surgery. Unipolar potentials were classified as single potentials (SPs), short double potentials (SDPs), long double potentials (LDP), fractionated potentials (FPs) and fraction duration (FD). The proportion of conduction block lines was also determined.
Female patients had a higher proportion of SDPs, LDPs and FPs at the RA, and SDPs at BB. At the PVA, there were less SPs and more SDPs and FPs. In females, FDs were longer at the RA and PVA, and potential voltages of only SPs were lower at the RA (all P < 0.05). Females also had more CB at the RA and at PVA (P < 0.05).
In females, the proportion of single unipolar potentials indicative of smooth conduction, was lower compared to males, at the RA and PVA and to a lesser degree at BB. Females also had more CB at RA and PVA. Hence, these results may reflect sex-differences in the degree of electrical remodeling.
传导障碍区域在房颤的起始和持续过程中起着重要作用，并且可通过单极电位形态的特定变化来识别。例如，由于纤维化条索等结构屏障导致相邻心肌细胞异步激活，可能会引起心内膜电图碎裂。然而，单极电位形态是否存在性别差异尚不清楚。因此，比较了男性和女性患者在窦性心律（SR）期间的心房电位形态。
基于倾向评分匹配，选取了62例男性和女性患者，这些患者在冠状动脉搭桥手术和/或心脏瓣膜手术期间对右心房（RA）、左心房（LA）以及包括巴赫曼束（BB）在内的肺静脉区域（PVA）进行了高分辨率标测。单极电位分为单电位（SPs）、短双电位（SDPs）、长双电位（LDP）、碎裂电位（FPs）和碎裂持续时间（FD）。还确定了传导阻滞线的比例。
女性患者在RA处SDPs、LDPs和FPs的比例较高，在BB处SDPs比例较高。在PVA处，SPs较少，SDPs和FPs较多。在女性中，RA和PVA处的FD较长，仅RA处SPs的电位电压较低（所有P<0.05）。女性在RA和PVA处也有更多的传导阻滞（P<0.05）。
在女性中，与男性相比，RA和PVA处指示传导顺畅的单极电位比例较低，在BB处程度较轻。女性在RA和PVA处也有更多的传导阻滞。因此，这些结果可能反映了电重构程度的性别差异。
