经心内和食管快速心房刺激对P波时限及离散度的影响  

Effects of intracardiac and esophageal rapid atrial pacing on P wave duration and dispersion.

作　　者：冼健坤[1] 朱立光 桂春[2] 郑剑光[1] 陈蒙华[1] 何涛[1] 

机构地区：[1]广西医科大学第一附属医院心电诊断科,广西南宁530021 [2]广西心血管病研究所心内科

出　　处：《中国心脏起搏与心电生理杂志》2006年第3期239-241,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：广西壮族自治区教育厅科研项目(桂教200322号)

摘　　要：目的分析快速心房刺激对P波时限及离散度的影响。方法在74例射频消融术经电极导管起搏高位右房及82例经食管心房调搏检查者中,用180次/分的S1S1刺激心房3min,在刺激前后立刻记录12导同步心电图,通过心电图测出刺激前后的最大P波时限(Pmax)、最小P波时限(Pmin)及P波离散度(Pd),然后进行比较。结果:射频消融组Pmax在心房刺激后比刺激前有显著性延长(P<0.01),Pmin及Pd无显著性差异。食管心房调搏组Pmax及Pd在心房刺激后显著性增加(P<0.01),Pmin无显著性差异。结论:快速心房刺激能引起心房传导时间延长,非均质电活动的离散程度增加。Objective To analyse the effects of rapid atrial pacing on p wave duration and dispersion. Methods We selected 74 radiofrequency catheter ablation cases who were paced in high right atrium and 82 transoesophageal atrial pacing cases. All subjects were performed by rapid atrial pacing（ S1 S2 ） with 180 beats per minutes,and 3 minutes pacing. 12-lead electrocardiogram was recorded instantly before and after rapid atrial pacing, and maximum P wave duration （Pmax）, minimum P wave duration（ Pmin ） and P wave dispersion （Pd） were measured from 12-lead electrocardiogram. Results In radiofrequency catheter ablation group, Pmax increased significantly after atrial pacing （P 〈 0.01 ）, but conversely, there were no significant difference in Pmin and Pd. In transoesophageal atrial pacing group, as compared to parameters before atrial pacing, Pmax and Pd increased statistically （P 〈 0.01 ）, but Pmin remained unchanged. Conclusions Rapid atrial pacing can increase atrial conduction time, as well as regional electrical heterogeneity.

关 键 词：心血管病学 P波时限 P波离散度 快速心房起搏 射频消融 导管电流 食管心房调搏 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]