心房颤动患者冠状窦电传导特点

Electrical conduction characteristics of the coronary sinus in patients with atrial fibrillation

目的研究阵发性心房颤动（PAF）患者冠状窦（CS）电传导的特性。方法病例组为PAF患者23例,对照组为阵发性室上性心动过速或室性早搏患者19例。期前程序S1S2 500/350 ms开始递减,步长-10 ms测量冠状窦电极1-2极、冠状窦电极9-10的有效不应期。应用固定程序S1S1 500、400、350、300、280 ms分别起搏冠状窦的远端、近端,测量CS远端到近端及CS近端到远端的传导时间。结果对照组和房颤组的冠状窦近端、远端不应期差异无统计学意义（P〉0.05）;冠状窦近端到远端的传导时间,S1S1随着递减起搏400-350ms差异有统计学意义（P〈0.05）;冠状窦远端到近端的传导时间,S1S1随着递减起搏350-280 ms差异有统计学意义（P〈0.05）;结论在阵发性房颤患者中冠状窦组织电传导延缓可能参与房颤的促发及维持。

[Objective] Electrical conduction properties of the coronary sinus in patients with paroxysmal atrial fibrillation （paroxysmal atrial fibrillation, PAF）. [Methods] Cases were 23 patients with PAF： control group were 19 patientsparoxysmal with supraventricular tachyeardia or ventricular premature beats. Period before the program S1S2 500/350 ms start decreasing step 10 ms measuring coronary sinus electrode 1- 2 pole, coronary sinus electrode effective refractory period 9- 10. Applications were fixed program S1S1 500, 400, 350, 300, 280 ms pacing coronary sinus （coronary sinus CS） distal, proximal, distal to proximal CS measure conduction time; CS proximal to distal conduction time. [Results] The control group and the AF group of coronary sinus proximal, distal refractory period was no significant difference （P 〉0.05）; proximal to distal coronary sinus conduction time, S1Sl pacing 400- 350 ms with diminishing differences there was statistically significant （P〈0.05）; coronary sinus distal to proximal conduction time, S1S1 pacing 350- 280 ms with diminishing difference was statistically significant （P〈0.05）. [Conclusion] In patients with paroxysmal atrial fibrillation the coronary sinus tissue electrical conduction delay may be involved in precipitating and maintaining atrial fibrillation.