Dobmeyer D J, Stine R A, Leier C V, Schaal S F
Am J Cardiol. 1985 Oct 1;56(10):602-4. doi: 10.1016/0002-9149(85)91019-7.
To examine the electrophysiologic determinants of provoked atrial flutter (AF) in patients with mitral valve prolapse (MVP), studies were performed in 4 groups of patients: group 1 (n = 5), patients with MVP and AF; group 2 (n = 6), patients without MVP but with AF; group 3 (n = 6), patients with MVP but without AF; and group 4 (n = 5), patients without MVP and without AF. P-wave duration, intraatrial conduction, interatrial conduction and effective refractory periods for both the high right atrium and the low right atrium were longer in group 2 than in group 1. The effective refractory period of the low right atrium was longer in group 3 than in group 1. The interatrial conduction interval was longer in group 2 than in group 4. Thus, in patients without MVP, atrial conduction delay is the predominant determinant of AF, whereas differences in right atrial refractoriness appear to be most important to the provocation of AF in the patient with MVP. These differences in atrial refractoriness may be a result of abnormal autonomic influences in patients with MVP.
为研究二尖瓣脱垂（MVP）患者中诱发心房颤动（AF）的电生理决定因素，对4组患者进行了研究：第1组（n = 5），患有MVP和AF的患者；第2组（n = 6），无MVP但患有AF的患者；第3组（n = 6），患有MVP但无AF的患者；第4组（n = 5），无MVP且无AF的患者。第2组的P波时限、右心房内传导、房间传导以及高位右心房和低位右心房的有效不应期均长于第1组。第3组低位右心房的有效不应期长于第1组。第2组的房间传导间期长于第4组。因此，在无MVP的患者中，心房传导延迟是AF的主要决定因素，而右心房不应期的差异似乎对MVP患者诱发AF最为重要。这些心房不应期的差异可能是MVP患者自主神经影响异常的结果。
