快速心房刺激对P波时限及离散度的影响

Effects of rapid atrial pacing on P wave duration and dispersion

目的分析快速心房刺激对P波时限及离散度的影响。方法在74例射频消融术及82例经食管心房调搏检查中,用180ppm的S1S1刺激心房3min,在刺激前后立刻记录12导联同步心电图,通过心电图测出刺激前后的最大P波时限、最小P波时限及P波离散度,然后进行比较。结果射频消融组最大P波时限在心房刺激后比刺激前有显著性延长(p=0.002),最小P波时限及P波离散度无显著性差异,食管心房调搏组最大P波时限及P波离散度在心房刺激后比刺激前有显著性增加(p=0.001),最小P波时限无显著性差异。结论快速心房刺激能引起心房传导时间延长,非均质电活动的离散程度增加。最大P波时限及P波离散度是可以用来评价心房电重构的简便而无创的指标。

Objective To analyse the effects of rapid atrial pacing on P wave duration and dispersion. Methods We selected 74 cases of radiofrequency catheter ablation and 82 cases of trans esophageal atrial pacing, all subjects were performed by rapid atrial pacing（SiS1） with 180 ppm,kept pacing 3 minutes.12-1ead electrocardiogram was recorded instantly before and after rapid atrial pacing,maximum and minimum P wave duration and P wave dispersion were measured from 12-lead electrocardiogram. Results In radiofrequency catheter ablation group,maximum P wave duration was increased significantly after atrial pacing compared with the values before atrial pacing（p=0.002）, conversely,there were no significant difference in minimum P ,wave duration and P wave dispersion in transesophageal atrial pacing group. As compared to parameters before atrial pacing,maximum P wave duration and P wave dispersion increased statistically （p=0.001）,but minimum P wave duration remain unchanged. Conclusion Rapid atrial pacing can increase atrial conduction time,as well as regional and electrical heterogeneity. Maximum P wave duration and P wave dispersion are simple and noninvasive parameters which can be used for estimating atrial electrical remodeling.