Romano S, Pozzoni L, Beltrami A, Calosso E, Martinelli C, Croce L
G Ital Cardiol. 1982;12(12):878-83.
Recent reports have shown that it is possible to record sinus node potential (SNP) using a transvenous electrode catheter technique in animals and in man. We applied similar techniques to record sinoatrial activity in 24 normal subjects and in 6 patients with sick sinus syndrome. We used bipolar recordings, with one interelectrode distance of 1 cm, low-pass filters of 0.1-50 Hz and high-amplification (up to 100 microV/cm). Validation of the source of the sinus node electrograms (SNE) was obtained by using ad hoc criteria. Like SNE recorded in animals, human SNE shows a smooth, low-frequency upstroke slope that begins before and merges into atrial activation. Sinus node potential is separated from preceding T wave by an isoelectric plateau. In 24 subjects with normal sinus node function, the directly recorded sinoatrial conduction time (D-SACT) was 82.9 +/- 17.9 msec. Correlation with the SACT estimated by Narula's method was excellent (r = 0,84). In 12 patients with sinus arrhythmia on SNE, SACTs were directly measured as were the associated P-P intervals. When SACT at each sinus cycle length (SCL) was plotted against SCL for all subjects grouped together, the average change of SAT per 100 msec change of SCL was 15 msec. In 6 patients with sick sinus syndrome, D-SACT was 150.4 +/- 67.4 msec. When SACT at each SCL was plotted against SCL, the average change of SACT per 100 msec change of SCL was 39 msec. In the same patients the SACT estimated by Narula's method was 129 +/- 17 msec.
最近的报告显示，使用经静脉电极导管技术在动物和人类中记录窦房结电位（SNP）是可行的。我们应用类似技术记录了24名正常受试者和6名病态窦房结综合征患者的窦房活动。我们采用双极记录，电极间距为1 cm，低通滤波器设置为0.1 - 50 Hz，高放大倍数（高达100 μV/cm）。通过使用特定标准对窦房结电图（SNE）的来源进行了验证。与在动物中记录的SNE一样，人类SNE显示出一个平滑的低频上升斜率，该斜率在心房激活之前开始并融入心房激活。窦房结电位与前一个T波之间由一个等电位平台分隔。在24名窦房结功能正常的受试者中，直接记录的窦房传导时间（D - SACT）为82.9±17.9毫秒。与通过纳鲁拉方法估算的SACT相关性极佳（r = 0.84）。在12名SNE显示窦性心律失常的患者中，直接测量了SACT以及相关的P - P间期。当将所有受试者在每个窦房周期长度（SCL）下的SACT与SCL作图时，SCL每变化100毫秒，SAT的平均变化为15毫秒。在6名病态窦房结综合征患者中，D - SACT为150.4±67.4毫秒。当将每个SCL下的SACT与SCL作图时，SCL每变化100毫秒，SACT的平均变化为39毫秒。在同一组患者中，通过纳鲁拉方法估算的SACT为129±17毫秒。
