摘要
观察房间隔起搏对阵发性心房颤动 (AF)患者最大P波时限 (Pmax)及P波离散度 (Pd)的影响 ,探悉房间隔起搏防治AF发作的电生理机制。对 2 1例阵发性AF患者和 2 6例室上性心动过速行射频消融术无阵发性AF患者 ,分别进行右心耳和房间隔起搏 ,比较不同部位起搏对阵发性AF和无阵发性AF患者的Pmax和Pd影响。结果 :阵发性AF患者较无阵发性AF患者Pmax和Pd值明显大 (分别为 1 35± 1 5vs 1 1 9± 1 4ms ,P <0 .0 5 ;36 .5± 9.2vs 1 9.7± 7.1ms ,P <0 .0 1 ) ;房间隔起搏使阵发性AF患者Pd、Pmax显著下降 (分别为 2 3 .4± 8vs 36 .5± 9.2ms ,1 2 0± 1 1vs1 35± 1 5ms,P均 <0 .0 5) ;右心耳起搏使无阵发性AF患者Pmax和Pd明显增加 (分别为 1 32± 1 2vs 1 1 9± 1 4ms,2 5 .5± 8.5vs 1 9.7± 7.1ms ,P均 <0 .0 5)。结论 :右心耳起搏能够使无阵发性AF患者Pmax和Pd值增加。房间隔起搏能够明显降低阵发性AF患者Pmax、Pd ,纠正房内或房间传导延缓 ,改善心房内电活动的各向异性 。
To investigate the effect of atrial septal pacing on p-wave duration maxi mum(Pmax),dispersion(Pd) in patients with paroxysmal atrial fibrillation(AF),21 patients with paroxysmal AF and 26 patients without paroxysmal AF were studied b y Pmax,Pd during sinus rhythm,right atrial appendage pacing and atrial septal pa cing.Results:Pmax and Pd in patients with paroxysmal AF tended to be greater tha n that in patients without paroxysmal AF(135±15 vs 119±14 ms, P< 0.05 an d 36. 5±9.2 vs 19.7±7.1 ms, P<0.01 ;respectively).In patients with paroxysmal AF,P max and Pd at atrial septal pacing were significantly shortened than during sinu s rhythm(120±11 vs 135±15 ms,23.4±8 vs 36.5±9.2 ms;all P< 0.05 ) .In pa tien ts without paroxysmal AF,Pmax and Pd at atrial appendage pacing were significant ly enlarged(132±12 vs 119±14 ms, 25.5 ±8.5 vs 19.7±7.1 ms,all P<0.05 ). Conc lusion:Right atrial appendage pacing can enlarge Pmax and Pd in patients without paroxysmal AF,may be arrhythmogenic for AF.Atrial septal pacing can decrease th e degree of Pmax and Pd,may be effective in preventing AF onset.
出处
《中国心脏起搏与心电生理杂志》
2002年第5期335-337,共3页
Chinese Journal of Cardiac Pacing and Electrophysiology
