Rowland E, Curry P, Fox K, Krikler D
Br Heart J. 1981 Jan;45(1):83-7. doi: 10.1136/hrt.45.1.83.
We have analysed the ventricular response as seen on the surface electrocardiogram in patients with paroxysmal atrial fibrillation and flutter in relation to the electrophysiological properties of the corresponding atrioventricular pathways. In 15 patients who had atrial fibrillation with conduction solely through the atrioventricular node, there was a significant correlation between th shortest and mean RR intervals during atrial fibrillation and the functional refractory period, "pre-Wenckebach cycle length", and the shortest ventricular cycle length that resulted from 1:1 atrioventricular conduction. In 18 patients with conduction through an accessory atrioventricular pathway the only good correlation was between the shortest and mean ventricular rate during atrial fibrillation and the "pre-Wenckebach cycle length" and shortest ventricular cycle length during 1:1 atrioventricular conduction. In 12 patients with an atriofascicular bypass tract or rapidly conducting atrioventricular node there was no significant correlation between the RR intervals during atrial fibrillation and the electrophysiological indices; the same lack of correlation was evident in all 11 patients with atrial flutter, all of whom had atrioventricular nodal conduction. The response of atrioventricular pathways to electrophysiological testing, particularly the use of incremental atrial pacing, provides useful guidance in the further management of these atrial arrhythmias.
我们分析了阵发性心房颤动和心房扑动患者体表心电图上的心室反应，并将其与相应房室传导途径的电生理特性相关联。在15例仅通过房室结传导的心房颤动患者中，心房颤动期间最短和平均RR间期与功能不应期、“文氏周期前周期长度”以及1:1房室传导导致的最短心室周期长度之间存在显著相关性。在18例通过房室旁道传导的患者中，唯一良好的相关性存在于心房颤动期间最短和平均心室率与“文氏周期前周期长度”以及1:1房室传导期间最短心室周期长度之间。在12例患有房束旁道或快速传导房室结的患者中，心房颤动期间的RR间期与电生理指标之间无显著相关性；在所有11例心房扑动患者中同样缺乏相关性，所有这些患者均通过房室结传导。房室传导途径对电生理检查的反应，尤其是递增性心房起搏的应用，为这些房性心律失常的进一步治疗提供了有用的指导。
