【摘要】 目的　对阵发性心房颤动 (房颤 )患者心房内阻滞的情况进行评价。方法　入选 78例阵发性房颤患者和 80例无阵发性房颤的射频消融患者 ,电生理检查时分别放置高位右心房、希氏束、冠状静脉窦电极导管作起搏和标测用 ,在高位右心房进行S1S2 程序刺激 ,S1刺激固定于 5 0 0ms ,S2 从45 0ms开始 ,- 10ms扫描 ,记录不同刺激时心房内和心房间传导时间及心房不应期。结果　S1刺激时阵发性房颤组和对照组S1 AHB间期分别为 (5 6 7± 15 4 )ms和 (6 0 8± 14 2 )ms;S1 ACSd间期在两组分别为 (110 2± 2 4 3)ms和 (10 7 5± 2 5 6 )ms;差异均无显著性 (P >0 0 5 )。S2 刺激时 ,心房内传导时间最长延长 1倍以上的患者在两组分别为 15 / 78例和 11/ 80例 ,心房间传导最长延长 1倍以上的患者在两组间分别为 13/ 78例和 9/ 80例 ,两组间差异无显著性 (P >0 0 5 )。心房不应期在两组分别为 (2 18 0±2 8 2 )ms和 (2 16 0± 2 4 7)ms,两者间差异无显著性 (P >0 0 5 )。结论　多数阵发性房颤患者无明显的心房内阻滞和不应期改变 ,传导时间延长也并非特异地发生在阵发性房颤组 ,提示心房内阻滞和不应期缩短在阵发性房颤的发生中的作用尚不明确。更多还原

【Abstract】 Objective The study was designed to evaluate the inter- and intra-atrial conduction disturbance in patients with paroxysmal atrial fibrillation.Methods Seventy eight patients with paroxysmal atrial fibrillation and 80 patients undergoing radiofrequency therapy without history of atrial fibrillation were enrolled into this study. Catheters were placed at the high right atrium, His bundle and coronary sinus for both pacing and recording. S 1S 2 program stimulation was performed at high right atrium with a driving cycle length of 500 ms and scanned from 450 ms to the effective refractory period of the atrium with a step length of -10 ms. S 1-A HB and S 1-A CSd intervals as well as atrial effective refractory period were recorded. Results During baseline atrium pacing rhythms, the S 1-A HB intervals were(56.7±15.4) ms and(60.8±14.2) ms while S 1-A CSd intervals were(110.2±24.3) ms and (107.5±25.6) ms in atrial fibrillation group and control group respectively, there was no statistically significant difference. S 1-A HB intervals prolonged more than one time were found in15 patients in the atrial fibrillation group whereas 11 in the control group. S 1-A CSd intervals doubled or more in 13 and 9 patients respectively in the two groups, there was no significant difference. The mean effective refractory periods of the atriums were(218.0±28.2) ms and(216.0±24.7) ms respectively, there was still no significan difference.Conclusion Most atrial fibrillation patients have no obvious intra- and inter-atrial conduction delay, and the intra-and inter-atrial conduction delay is not specific for the atrial fibrillation, nor is the shortening of the effective refractory period of the atrium. The role of intra-and inter-atrial conduction delay and the shortening of the effective refractory period in atrial fibrillation remain controversial.更多还原