Jaïs P, Haïssaguerre M, Shah D C, Chouairi S, Clémenty J
Hôpital Cardiologique du Haut-Lévêque, Bordeaux, France.
Pacing Clin Electrophysiol. 1996 Nov;19(11 Pt 2):1998-2003. doi: 10.1111/j.1540-8159.1996.tb03269.x.
Previous experimental data suggest that atrial activity is homogeneously distributed during paroxysmal atrial fibrillation (AFib). Little is known about this in human paroxysmal AFib.
Twenty-five men and two women (mean age 49 +/- 11 years; five with structural heart disease) with paroxysmal AFib for a mean 5 +/- 6.2 years despite the use of a mean of 3.6 +/- 1.7 antiarrhythmic drugs underwent atrial mapping. The right atrium was divided into four regions: posterior (intercaval), lateral, anterior, and septal. A 14-pole catheter was positioned to assess complex electrical activity defined as the duration of continuous electrical activity or electrograms with FF intervals < 100 ms for 60 seconds (expressed as percentage of time). In addition, the left atrium (divided into three regions: posterior, anterior, and septal) was explored in 12 patients with a multipolar catheter.
The complex electrical activity time between all the regions explored was significantly different. In the right atrium, the septal (74% +/- 32%; P = 0.02) and the posterior (63% +/- 32%; P = 0.04) areas were significantly more disorganized than the lateral (22% +/-23%) and anterior (21% +/- 26%) regions. In the left atrium, complex electrical activity was predominant and widely distributed (posterior: 87% +/- 11%; septal: 65% +/- 27%) except in the appendage area (anterior region: 18% +/- 14%).
Quantitative assessment of complex electrical activity in both atria in humans shows heterogeneous temporal and spatial distribution. This may have implications for guiding catheter ablation of AFib.
先前的实验数据表明，阵发性心房颤动（AFib）期间心房活动呈均匀分布。关于人类阵发性AFib的这方面情况知之甚少。
25名男性和2名女性（平均年龄49±11岁；5人患有结构性心脏病），尽管平均使用了3.6±1.7种抗心律失常药物，但仍患有阵发性AFib平均5±6.2年，接受了心房标测。右心房被分为四个区域：后部（腔静脉间）、外侧、前部和间隔部。放置一根14极导管以评估复杂电活动，定义为连续电活动或FF间期<100 ms的心电图持续60秒的时间（以时间百分比表示）。此外，在12名患者中使用多极导管对左心房（分为三个区域：后部、前部和间隔部）进行了探查。
所有探查区域之间的复杂电活动时间存在显著差异。在右心房，间隔部（74%±32%；P = 0.02）和后部（63%±32%；P = 0.04）区域的紊乱程度明显高于外侧（22%±23%）和前部（21%±26%）区域。在左心房，除了心耳区域（前部区域：18%±14%）外，复杂电活动占主导且分布广泛（后部：87%±11%；间隔部：65%±27%）。
对人类双心房复杂电活动的定量评估显示出时间和空间分布的异质性。这可能对指导AFib的导管消融有影响。
