Tzivoni D, Jordan J, Mandel W J, Barrett P A, Fink B, Yamaguchi I
J Electrocardiol. 1982 Oct;15(4):317-24. doi: 10.1016/s0022-0736(82)81003-0.
125 consecutive patients with premature atrial stimulation were studied. Three demonstrated sinus node return cycles that were fully compensatory following premature atrial stimuli delivered early in diastole. This second zone of compensation was unaccompanied by significant alterations in the post-return cycle lengths or in P-wave morphology of the return cycle. To account for the occurrence of a complete compensatory pause following very early premature atrial depolarizations, we consider the possibility that retrograde conduction of the early atrial premature depolarization (APD) in the sinoatrial junction was delayed for a sufficient length of time to allow the sinus node to depolarize spontaneously on schedule. Collision between the APD and sinus beat would then occur despite the marked prematurity of the APD. Thus, the early APD had encountered the relative refractory period of the sinoatrial junction, suggesting that decremental conduction takes place within the sinoatrial region in man. These findings imply that there is the potential for reentry in the region of the human sinoatrial junction.
对125例房性早搏患者进行了研究。3例患者在舒张早期给予房性早搏刺激后，出现了完全代偿性的窦房结恢复周期。这种第二个代偿区在恢复周期长度或恢复周期的P波形态上没有明显改变。为了解释极早期房性早搏后出现完全代偿间歇的原因，我们考虑了这样一种可能性，即房性早搏早期去极化（APD）在窦房交界区的逆行传导延迟了足够长的时间，以使窦房结按计划自发去极化。尽管APD明显提前，但APD与窦性搏动之间仍会发生碰撞。因此，早期APD遇到了窦房交界区的相对不应期，提示在人类窦房区域发生了递减传导。这些发现意味着人类窦房交界区存在折返的可能性。
