Ohsugi S, Hayashi H, Ishikawa T, Yabe S, Kojima H, Takami K, Muramatsu H, Kato R, Sotobata I
J Cardiogr. 1984 Aug;14(2):323-34.
Nine patients of sick sinus syndrome with atrial programmable pacemaker (3 males and 6 females, aged from 53 to 72 years) were studied to assess the effect of heart rate on the body surface potential distribution. Body surface maps (87 lead points) and M-mode echocardiograms were recorded at 20-beat increments of heart rate from 60 to 140 beats/min during atrial pacing. The potential changes of R and S voltages were evaluated quantitatively and were correlated with the changes of echocardiographically measured left ventricular dimension. As the heart rate increased, left ventricular dimension in end-diastole (LVDd) decreased gradually (Table 1), and a significant decrease was observed when the heart rate increased from 80 to 100 beats/min and from 100 to 120 beats/min, respectively, (p less than 0.05). With a decrease in LVDd, the distance between the left ventricular posterior wall and the anterior chest wall decreased and the left ventricular wall increased in its thickness. These changes, however, were not statistically significant. With an increase in the heart rate, R voltages decreased gradually in the left lateral chest and the sum of R voltages (sigma R) of six lead points in the left lateral chest including leads V5-6 decreased significantly when the heart rate increased from 60 to 100 beats/min and from 80 to 120 beats/min, respectively (p less than 0.02) (Table 2). On the other hand, R voltages remained unchanged in the left anterior chest during atrial pacing, then the sum of R voltages of six lead points in the left anterior chest including leads V2-4 and the sum of R voltages of 87 lead points did not show any significant changes (Table 2). An increase in the absolute value of S voltages was observed in the left anterior chest and the sum of S voltages of six lead points in the left anterior chest including leads V2-4 increased when the heart rate increased from 60 to 100 beats/min and from 80 to 120 beats/min, respectively (p less than 0.1) (Table 3) A decrease of R voltages in the left lateral chest was consistent with the reduction in LVDd (p less than 0.005). It is concluded that the changes in body surface QRS amplitudes during atrial pacing are related to those in the left ventricular dimension and that R voltages in the left lateral chest are fairly sensitive to see the changes in LVDd in cases with no abnormal wall motion of the left ventricle.(ABSTRACT TRUNCATED AT 400 WORDS)
对9例患有病态窦房结综合征并植入心房程控起搏器的患者（3例男性，6例女性，年龄53至72岁）进行了研究，以评估心率对体表电位分布的影响。在心房起搏期间，以每分钟60至140次心跳、每次心跳增加20次的心率增量记录体表图（87个导联点）和M型超声心动图。对R波和S波电压的电位变化进行了定量评估，并将其与超声心动图测量的左心室尺寸变化相关联。随着心率增加，舒张末期左心室尺寸（LVDd）逐渐减小（表1），当心率分别从80次/分钟增加到100次/分钟和从100次/分钟增加到120次/分钟时，观察到显著减小（p小于0.05）。随着LVDd减小，左心室后壁与前胸壁之间的距离减小，左心室壁厚度增加。然而，这些变化无统计学意义。随着心率增加，左外侧胸部的R波电压逐渐降低，当心率分别从60次/分钟增加到100次/分钟和从80次/分钟增加到120次/分钟时，左外侧胸部包括V5 - 6导联在内的6个导联点的R波电压总和（σR）显著降低（p小于0.02）（表2）。另一方面，心房起搏期间左前胸部的R波电压保持不变，那么左前胸部包括V2 - 4导联在内的6个导联点的R波电压总和以及87个导联点的R波电压总和均未显示任何显著变化（表2）。当心率分别从60次/分钟增加到100次/分钟和从80次/分钟增加到120次/分钟时，观察到左前胸部S波电压绝对值增加，左前胸部包括V2 - 4导联在内的6个导联点的S波电压总和增加（p小于0.1）（表3）。左外侧胸部R波电压降低与LVDd减小一致（p小于0.005）。结论是，心房起搏期间体表QRS波振幅的变化与左心室尺寸的变化相关，并且在左心室壁运动无异常的情况下，左外侧胸部的R波电压对观察LVDd的变化相当敏感。（摘要截选至400字）
