Yamada T, Fukunami M, Abe Y, Hoki N
Division of Cardiology, Osaka Prefectural Hospital.
Nihon Rinsho. 1995 Feb;53(2):503-9.
We investigated the spatial distribution of atrial late potentials (ALP) in patients with paroxysmal atrial fibrillation (Paf) by use of body surface signal-averaged ECG. The P wave-triggered signal-averaged ECG was recorded in 20 patients with Paf and 34 control patients from precordial 16 unipolar leads (standard V1-V6 and two intercostal spaces below and above V1, V2, V4-V6). The duration (Ad) and number of fragmented deflection (Nf) of filtered P wave were measured on each lead. % Area was also calculated by dividing the area for the last 20 msec by the total area of filtered P wave. The lead having any of a significantly longer Ad, larger Nf and smaller % Area in patients with Paf than the controls was designated as ALP positive lead. ALPs were observed in all other than two intercostal spaces above V5 and V6. This finding suggests that the electrophysiological disparity in the whole atrial muscle might be involved in patients with Paf.
我们通过体表信号平均心电图研究了阵发性心房颤动(Paf)患者心房晚期电位(ALP)的空间分布。对20例Paf患者和34例对照患者从胸前16个单极导联(标准V1-V6以及V1、V2、V4-V6上下两个肋间间隙)记录P波触发的信号平均心电图。在每个导联上测量滤波后P波的持续时间(Ad)和碎裂波数量(Nf)。还通过将最后20毫秒的面积除以滤波后P波的总面积来计算%面积。与对照组相比,Paf患者中Ad明显更长、Nf更大且%面积更小的任何一个导联被指定为ALP阳性导联。除了V5和V6上方的两个肋间间隙外,在所有其他部位均观察到了ALP。这一发现表明,整个心房肌的电生理差异可能与Paf患者有关。