Bexton R S, Nathan A W, Hellestrand K J, Cory-Pearce R, Spurrell R A, English T A, Camm A J
Br Heart J. 1983 Dec;50(6):555-63. doi: 10.1136/hrt.50.6.555.
Fourteen relatively long term survivors of cardiac transplantation underwent systematic electrophysiological evaluation and ambulatory electrocardiographic monitoring. Six patients had prolonged conduction intervals during sinus rhythm. Sinus node function could be assessed in all donor atria and in 10 recipient atria. Sinus node recovery times were prolonged in four of the donor atria and in six recipient atria. In the donor atria abnormalities of sinus node automaticity were invariably associated with abnormalities of sinoatrial conduction. Four patients showed functional duality of atrioventricular nodal conduction during programmed extrastimulation, but no patient developed re-entrant arrhythmia. During ambulatory electrocardiographic monitoring no pronounced tachyarrhythmias were recorded. Three patients showed abnormalities of sinus node impulse formation. All three patients had abnormal sinus node recovery times during their electrophysiological study. Long term survivors of cardiac transplantation have a high incidence of electrophysiological abnormalities. Abnormalities of donor sinus node function are probably of clinical significance. The clinical significance of abnormalities detected within the atrioventricular conduction system of the denervated heart remains to be elucidated.
14名心脏移植相对长期存活者接受了系统的电生理评估和动态心电图监测。6例患者在窦性心律时传导间期延长。所有供体心房和10例受体心房均可评估窦房结功能。4例供体心房和6例受体心房的窦房结恢复时间延长。在供体心房中，窦房结自律性异常总是与窦房传导异常相关。4例患者在程序刺激时显示房室结传导功能双重性，但无患者发生折返性心律失常。在动态心电图监测期间，未记录到明显的快速心律失常。3例患者显示窦房结冲动形成异常。所有3例患者在电生理研究期间窦房结恢复时间均异常。心脏移植长期存活者电生理异常发生率高。供体窦房结功能异常可能具有临床意义。去神经心脏房室传导系统内检测到的异常的临床意义仍有待阐明。
