Khalilullah M, Shrestha N K, Padmavati S
J Electrocardiol. 1978 Oct;11(4):375-8. doi: 10.1016/s0022-0736(78)80144-7.
Ten patients with atrial septal defect of the secondum variety undergoing diagnostic haemodynamic study were subjected to electrical stimulation of the endocardium of the left atrium using a bipolar pacing electrode catheter. The polarity, frontal plane P wave axis and P wave configuration were analysed from ten scalar 12 lead electrocardiogram (ECG), recorded at 25-50 mm/sec during sinus rhythm and left atrial stimulation. While four patients demonstrated the "dome and dart" appearance of P waves in V1, nine out of ten patients revealed upright P waves in V1 during left atrial pacing; one patient showed inverted P waves in V1-V6. Four patients had negative "P" waves in L1 and only five of ten patients had inverted "P" waves in L1 and V6. All the criteria of left atrial rhythm were present in only one patient. It appears that the "P" waves change during left atrial pacing are variable and that the typical findings of left atrial rhythm are not obtained in all cases. This study was planned because trans-septal left atrial stimulation in the genesis of left atrial rhythm has not been widely reported.
对10例继发孔型房间隔缺损患者进行诊断性血流动力学研究，使用双极起搏电极导管对左心房内膜进行电刺激。在窦性心律和左心房刺激期间，以25 - 50毫米/秒的速度记录10份标量12导联心电图（ECG），分析其极性、额面P波电轴和P波形态。虽然4例患者在V1导联显示出“圆顶和箭头”样P波，但10例患者中有9例在左心房起搏时V1导联P波直立；1例患者V1 - V6导联P波倒置。4例患者L1导联“P”波为负，10例患者中只有5例L1导联和V6导联“P”波倒置。仅1例患者具备左心房节律的所有标准。看来左心房起搏期间“P”波的变化是可变的，并非所有病例都能获得左心房节律的典型表现。开展这项研究是因为经房间隔左心房刺激在左心房节律发生中的情况尚未得到广泛报道。
