摘要
目的探讨预激综合征患者阵发性房颤发生的可能机制。方法127例预激综合征合并旁道介导的阵发性心动过速患者,根据既往有无阵发性房颤发作,分为阵发性房颤发作组(n=23)和无阵发性房颤发作组(n=104)。电生理检查测定旁道的前传和逆传不应期;消融术术后24h描记12导联心电图,测量P波最大时限、最小时限,计算P波离散度。结果阵发性房颤发作组与无阵发性房颤发作组比较,射频消融术中旁道存在逆传者的数量无显著差别(87.0%vs91.3%)(P>0.05);前者消融术前旁道前传和逆传不应期显著短于后者(P<0.01),消融术后心电图P波最大时限和离散度显著长于后者(P<0.01)。结论在预激综合征患者房颤发生中,旁道有效不应期缩短和窦性激动在心房内的非均质传导起重要作用。
Objective To investigate the mechanism of paroxysmal atrial fibrillation （PAF） in patients with Wolff Parkinson-White （WPW） syndrome. Methods One hundred and twenty-seven patients with WPW who underwent radiofrequency catheter ablation due to paroxysmal tachycardia mediated by overt accessory pathways were enrolled in this retrospective study. All patients were evaluated by electrophysiological study to measure the effective refractory period of antegrade and retrograde accessory pathways. The patients were classified into two groups, 23 with previous PAF attacks and 123 without. After successful ablation, P-wave dispersion was calculated in the 12-lead surface electrocardiogram, and the echocardiographic findings, P-wave maximum duration and P-wave dispersion values were compared. Results The rates of presense of retrograte conduction in accessory pathways were not different between the two groups（87.0% vs 91.3% ,P 〉0.05）. Accessory pathway antegrade and retrograde effective refractory period values were shorter in patients with PAF attacks （P 〈0.01）. P-wave maximum duration and P-wave dispersion values measured after ablation were significantly higher in patients with documented previous PAF attacks （P 〈 0.01 ）. Conclusion The shortening of effective refractory periods of accessory pathways and heterogeneous propagation of sinus impulses in the atrium may play an important role in the occurrence of atrial fibrillation in patients with WPW.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2006年第3期249-251,共3页
Journal of Shanghai Jiao tong University:Medical Science
关键词
电生理学
预激综合征
阵发性房颤
导管消融
P波离散度
心电描记术
electrophysiology
Wolff-Parkinson-White syndrome
paroxysma atrial fibrillation radiofrequency current
P- wave dispersion
electrocardiography
