风湿性心脏病慢性心房颤动f波振幅的电生理研究(英文)  

Electrophysiologic study of f-wave amplitude in chronic atrial fibrillation associated with rheumatic heart disease

作　　者：李莉[1] 贾宝成[1] 张宝仁[1] 汪曾炜[1] 朱家麟[1] 

机构地区：[1]第二军医大学长海医院胸心外科,上海200433

出　　处：《第二军医大学学报》2005年第2期127-130,共4页Academic Journal of Second Military Medical University

基　　金：the National Natural Science Fundation ofChina(30070749)

摘　　要：目的:对风湿性心脏病(风心病)慢性心房颤动(房颤)的房波电振幅特点进行研究,以探讨其在房颤产生和持续中的意义。方法:选择44例风心病慢性房颤患者在术前作16导左、右房同步心外膜标测图并进行分析,同时与10 例室上速(对照组)心内电生理检查结果进行比较。结果:风心病慢性房颤患者A波,左房后壁中、下部f波振幅明显低于对照组A波,左房后壁上、中、下部位f波振幅明显低于右房(P<0.05)。14 例房颤电复律后心房各部位的A波幅明显大于术前f波振幅(P<0.01),左心耳f波振幅显著大于左房后壁上、中、下部,左房后壁上部f波振幅显著大于左房后壁中部。风心病慢性房颤患者f波振幅与心房内径和容积无相关。结论: 左房后壁中、下部f波振幅最低,在左房心耳、左房上和左房中、下部之间存在明显电位差,提示左房中、下部是最易产生各向异性传导的部位,推测为AF起源,在明显电位差的部位易形成折返环。Objective: To investigate the electrophysiologic characteristics of f-wave amplitude and to evaluate its role in development and persistence of chronic atrial fibrillation (AF) associated with rheumatic heart disease (RHD). Methods: Epicardial mapping was performed in 44 patients with chronic AF of RHD who underwent heart valve surgery. Ten patients with supraventricular tachycardia served as the control group. Results:The f-wave amplitude of left atrium (LA) and middle and low LA posterior regions were significantly lower than those of the control group. The f-wave amplitudes of the upper, middle and low sections in LA posterior region were significantly lower than those in right atrium (RA) (P<0.05). The f-wave amplitudes were compared before and after electrocardioversion in 14 patients with chronic AF. The mean atrial electrogram amplitude during sinus rhythm was significantly higher than that during AF (P<0.01).The f-wave amplitude in left appendage was higher than that in LA posterior region (the upper,middle and the lower part),P<0.05.The f-wave amplitude in the upper section of LA was significantly higher than that in the middle section. The f-wave amplitude in AF group was not correlated to the diameter or volume of both atria. Conclusion: There are amplitudes differences between the upper, middle and lower LA,suggesting that the middle and lower sections of LA posterior wall may be the region producing anisotropy and reentrant circle.

关 键 词：风湿性心脏病 心房颤动 F波振幅 电生理学 

分 类 号：R541.2[医药卫生—心血管疾病]