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Title:: Influence of premature atrial beats and age on atrial conduction velocity

作者:: 王晶¹; ²; 梁延春¹; 王祖禄¹; 孙鸣宇¹; 马薇¹; 1.沈阳军区总医院心血管内科，辽宁沈阳 110016；2.北京华信医院心内科，北京 100016

Author(s):: WANG Jing; LIANG Yan-chun; WANG Zu-lu; SUN Ming-yu; MA Wei; Department of Cardiology, General Hospital, Shenyang Military Area Command, Shenyang 110016, Liaoning, China

关键词:: 期前收缩; 房性; 心房传导速度; 年龄

Keywords:: premature beats; atrial conduction velocity; aging

分类号:: R541.71

DOI:: -

文献标识码:: A

摘要:: 目的: 探讨房性期前收缩及年龄因素对人心房传导速度的影响。方法: 入选30例无器质性心脏病，因室上性心动过速行心脏电生理检查及射频消融术的患者，按年龄分为青年组、中年组和老年组。按能否诱发房颤，分为诱发房颤组与未诱发组。窦性心律时测定P波宽度，电生理检查测量心房有效不应期, 以及高位右房（HRA）-冠状静脉窦远端（CS）的传导时间（iaCT）。分别测量基础刺激S1(600 ms、500 ms、400 ms和300 ms)以及相应S1起搏时不同配对间期的期前刺激（心房有效不应期+2，4，6，8，10 ms）时的左右房传导速度。结果: 共有9例诱发房颤，老年组房颤诱发率显著高于青年组，诱发房颤组iaCT的延缓率高于非诱发组（均P<0.05）。老年组以及诱发房颤组P波明显增宽；期前刺激时心房传导速度明显减慢，iaCT明显延长（P<0.01）；期前刺激时老年组的心房传导速度较青年组减慢，老年组iaCT较青年组及中年组均明显延长（P<0.05）。结论: 老年人P波增宽，易出现房颤。各年龄组在房性期前收缩时心房传导速度均明显减慢；老年组较青年组减慢更明显。

Abstract:: AIM: To investigate the influence of premature beats on atrial conduction velocity (ACV) and age-related changes in patients. METHODS: Thirty patients who had no organic or structural disease and who were treated with electrophysiological and radiofrequency ablation for AVRT or AVNRT were included in the study. The patients were divided into groups by age and the inducibility of atrial fibrillation (AF), respectively. P-wave duration and conduction time were measured between high lateral right atrium (LRA) and distal CS (iaCT) in sinus rhythm. Atrial effective refractory period (AERP) at the distal coronary sinus (CS) and high LRA at the cycle length of 600, 500, 400 and 300 msec and ACV along the CS and LRA at S1 pacing and different coupling interval premature atrial complex were also measured. RESULTS: Sustained AF was induced in nine patients. Inducibility of AF in elderly patients was 60%, much higher than in young patients. In patients with induced AF, iaCT was much higher than that of patients without induced AF (P<0.05). ACV at premature atrial complex was much slower than basal pacing (P<0.01). Age was associated with an increase in P-wave duration and a decrease in ACV (P<0.05). CONCLUSION: Aging is associated with increased P-wave duration and inducibility of AF. ACV at premature atrial complex is much slower than basal pacing, especially in elderly patients.

参考文献/References

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房性期前收缩及年龄因素对人心房传导速度的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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