Anselme F, Saoudi N, Redonnet M, Letac B
Centre Hospitalier et Universitaire de Rouen, Hôpital Charles Nicolle, France.
J Am Coll Cardiol. 1994 Jul;24(1):185-9. doi: 10.1016/0735-1097(94)90561-4.
In two patients with orthotopic heart transplantation, the surface electrocardiogram suggested interaction between the donor right atrium and the recipient right atrium. An electrophysiologic investigation was performed to assess possible atrioatrial conduction.
After orthotopic heart transplantation, both recipient and donor atrial activities are usually independent, but in humans they may synchronize for short periods during exercise.
Electrophysiologic recordings were made using standard techniques. The atrial electrode locations (anterior for the donor and posterior for the recipient right atria) were confirmed by fluoroscopy. Incremental and programmed donor and recipient right atrial pacing protocols were performed.
Unidirectional conduction between native and graft atria occurred in both patients. This phenomenon was evident at rest, during normal sinus rhythm and at various pacing rates, resulting in frequent atrial bigeminy and trigeminy.
Possible atrioatrial conduction after orthotopic heart transplantation may potentially be arrhythmogenic for the chamber where extrasystoles occur. This should be taken into account in attempting to devise new pacing modes if both atria are rendered electrically common.
在两名原位心脏移植患者中，体表心电图提示供体右心房与受体右心房之间存在相互作用。进行了电生理检查以评估可能的房-房传导。
原位心脏移植后，受体和供体的心房活动通常是独立的，但在人类中，它们在运动期间可能会短时间同步。
使用标准技术进行电生理记录。通过荧光透视确认心房电极位置（供体右心房在前，受体右心房在后）。进行了递增和程控的供体和受体右心房起搏方案。
两名患者均出现了天然心房与移植心房之间的单向传导。这种现象在静息、正常窦性心律以及不同起搏频率时均很明显，导致频繁的房性二联律和三联律。
原位心脏移植后可能存在的房-房传导对于出现期前收缩的腔室可能具有潜在的致心律失常性。如果两个心房在电活动上变为共同的，那么在尝试设计新的起搏模式时应考虑到这一点。
