Chen Y J, Chen S A, Tai C T, Yu W C, Feng A N, Ding Y A, Chang M S
Department of Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan.
J Interv Card Electrophysiol. 1998 Jun;2(2):181-6. doi: 10.1023/a:1009759717250.
This study investigated the difference of atrial electrophysiologic characteristics between a normal and dilated atrium and compared them among patients with paroxysmal atrial fibrillation and flutter. Twenty-seven patients with paroxysmal atrial fibrillation and 28 patients with paroxysmal atrial flutter were divided into four subgroups, according to the presence of a normal atrium or bilateral atrial enlargement. Thirty patients without atrial arrhythmia (20 patients with normal atrium and 10 patients with bilateral atrial enlargement) were included in control group. The atrial refractoriness in patients with a dilated atrium was longer than those with normal atrial size. In patients with paroxysmal atrial fibrillation and patients of control group, the P-wave duration and interatrial conduction velocity with or without atrial enlargement were similar. However, in patients with paroxysmal atrial flutter, P-APCS (86 +/- 10 ms vs. 73 +/- 9 ms, p < 0.05) and P-ADCS (109 +/- 9 ms vs. 95 +/- 9 ms, p < 0.05) in patients with a dilated atrium were longer than in patients with a normal atrium. The patients with paroxysmal atrial fibrillation or atrial flutter all demonstrated longer P-wave duration and interatrial conduction time than control group. Among the groups with a normal atrium or a dilated atrium, atrial refractoriness in patients with paroxysmal atrial flutter was shorter than that in control group. Moreover, in the patients with a normal atrium, the potential minimal wavelength in control group (6.6 +/- 1.7) was longer than that of paroxysmal atrial fibrillation (5.3 +/- 1.1), or atrial flutter (5.0 +/- 1.2). These findings suggest that atrial electrophysiologic characteristics of a dilated atrium were different from those of normal atrium, and these changes were different between paroxysmal atrial fibrillation and flutter. Multiple factors are considered to be related to the genesis of atrial tachyarrhythmias.
本研究调查了正常心房与扩张型心房之间的心房电生理特征差异，并在阵发性心房颤动和心房扑动患者中进行了比较。27例阵发性心房颤动患者和28例阵发性心房扑动患者根据是否存在正常心房或双侧心房扩大分为四个亚组。30例无房性心律失常的患者（20例正常心房患者和10例双侧心房扩大患者）被纳入对照组。扩张型心房患者的心房不应期长于正常心房大小的患者。在阵发性心房颤动患者和对照组患者中，无论有无心房扩大，P波时限和房间传导速度相似。然而，在阵发性心房扑动患者中，扩张型心房患者的P-APCS（86±10 ms对73±9 ms，p<0.05）和P-ADCS（109±9 ms对95±9 ms，p<0.05）长于正常心房患者。阵发性心房颤动或心房扑动患者的P波时限和房间传导时间均长于对照组。在正常心房或扩张型心房组中，阵发性心房扑动患者的心房不应期短于对照组。此外，在正常心房患者中，对照组的潜在最小波长（6.6±1.7）长于阵发性心房颤动（5.3±1.1）或心房扑动（5.0±1.2）。这些发现表明，扩张型心房的心房电生理特征与正常心房不同，且这些变化在阵发性心房颤动和心房扑动之间存在差异。多种因素被认为与房性快速性心律失常的发生有关。
