Ismer B, Von Knorre G H, Voss W, Grille W, Klenke G, Pulya K, Koglek W, Suntinger A, Luessow H
University of Rostock, Clinic for Internal Medicine, Rostock, Germany.
Pacing Clin Electrophysiol. 1996 Nov;19(11 Pt 2):1786-90. doi: 10.1111/j.1540-8159.1996.tb03225.x.
Using telemetry, right atrial electrogram (RA), and marker channel of atrial sense events (MA) in combination with the left atrial electrogram (LA), recorded by a filtered bipolar esophageal lead, interatrial conduction during submaximal exercise and at rest was examined in 46 DDD pacemaker patients. The RA-LA and MA-LA conduction times measured in the presence of atrial sensing (VDD) as well as the conduction time SA-LA from atrial stimulus (SA) to LA, determined during atrial pacing (DDD) were found to be individual constants independent of exercise induced sympathetic influences. Thus, having determined an optimal mechanical interval (LA-LV)mech/opt from left atrium to ventricle by other methods, the optimal AV delay for DDD as well as for VDD operation can be calculated by the sum of the appropriate interatrial conduction time (SA-LA, respectively MA-LA) and the (LA-LV)mech/opt interval. Due to the constant SA-LA and MA-LA, the difference between these two values (AV delay correction interval) is a constant as well, which remains unchanged during exercise. Therefore, in selecting the rate responsive AV delay, only hemodynamic and not electrophysiological measurements need to be considered.
通过遥测技术、右心房电图（RA）、心房感知事件的标记通道（MA），结合经滤波的双极食管导联记录的左心房电图（LA），对46例DDD起搏器患者在次极量运动和静息状态下的房间传导进行了研究。发现在心房感知（VDD）时测量的RA-LA和MA-LA传导时间，以及在心房起搏（DDD）期间确定的从心房刺激（SA）到LA的传导时间SA-LA，是独立于运动诱发交感神经影响的个体常数。因此，通过其他方法确定了从左心房到心室的最佳机械间期（LA-LV）mech/opt后，DDD以及VDD操作的最佳房室延迟可通过适当的房间传导时间（分别为SA-LA和MA-LA）与（LA-LV）mech/opt间期之和来计算。由于SA-LA和MA-LA恒定，这两个值之间的差异（房室延迟校正间期）也是恒定的，在运动期间保持不变。因此，在选择频率适应性房室延迟时，只需考虑血流动力学而非电生理测量。
