风心病慢性房颤心外膜标测心房有效不应期的对比研究

目的:研究风心病慢性房颤的电生理特征。方法:对29例风心病伴或不伴慢性房颤的病人在行二尖瓣置换术时,采用心外膜标测技术测定左、右心房各部位的有效不应期(AERP)及右房内和房间的传导时间。结果:风心病慢性房颤组左、右心房AERP比窦性心律明显缩短(P<0.05),左、右心房各部分的AERF,之间有明显差异(P< 0.01),即存在明显离散性;慢性房颤组的右房和房间传导时间在转复为窦性心律和缩短刺激右房高位问期时均显著长于正常对照组(P<0.05)。结论:风心病慢性房颤心房各部位AERP的差异反映了其AERP的离散性,而AERP 的离散性在房颤的诱发和维持过程中起着重要作用。

Comparison of atrial effective refractory period by epicardial mapping in chronic atrial fibrillation patients with rheumatic heart disease

Objective: To investigate the electrical physiologic character of chronic atrial fibrillation (AF) in patients with rheumatic heart disease (RHD). Methods: A total of 29 RHD patients with or without AF underwent epicardial mapping during mitral replacement for detect atrial effective refractory period (AERP) of left and right atria and for right atrium conduction time and inter-atrium conduction time. Results: AERP of left and right atria in patients with AF was significantly shorter than that of patients with sinus rhythm (P<0. 05) , and there was significant difference of AERP in correspondent part of left atrium and right atrium (P<0. 01), in other words there was significant dispersion. After converting to sinus rhythm and shortening high right atrial stimulation interval, right atrium conduction time and inter-atrium conduction time in chronic AF group were significantly longer than those in sinus rhythm control group (P<0. 05). Conclusion:Difference of AERP in atrial different part reflect AERP dispersion which plays an important role in originating and maintaining of atrial fibrillation.