Response of pulmonary vein Potentials to premature stimulation
Response of pulmonary vein Potentials to premature stimulation
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DOI：
10.1046/j.1540-8167.2002.00033.x
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发表时间：
2002-01-01
影响因子：
2.7
通讯作者：
Morady, F
中科院分区：
文献类型：
--
作者：
Tada, H;Oral, H;Morady, F
简介：肺静脉电位反映了肺静脉周围心肌袖内肌束的去极化。肺静脉电位的反应过早stimulation.Methods和结果：在31例阵发性心房颤动的肺静脉节段性隔离，程控刺激与一个单一的心房extrastimulus进行了从冠状窦。使用十极Lasso导管记录双极和单极电描记图，该导管依次位于靠近开口的左上级、左下级和右上级肺静脉内。过早刺激常导致肺静脉内记录到的心房和肺静脉电位分离更大、肺静脉电位分离、肺静脉电位环周激动顺序改变和肺静脉电位丢失。为了应对过早的刺激，围绕肺静脉的心肌袖内的肌束显示出比相邻左心房中的心肌纤维更大程度的递减传导，并且它们在传导性能和耐火性方面显示出不均匀性。过早刺激可促进肺静脉电位与心房电图的区分。
Introduction: Pulmonary vein potentials reflect depolarization of muscle fascicles within the myocardial sleeves that surround the pulmonary veins. The response of pulmonary vein potentials to premature stimulation has not been described.Methods and Results: In 31 patients with paroxysmal atrial fibrillation referred for segmental isolation of the pulmonary veins, programmed stimulation with a single atrial extrastimulus was performed from the coronary sinus. Bipolar and unipolar electrograms were recorded with a decapolar Lasso catheter positioned sequentially within the left superior, left inferior, and right superior pulmonary veins, near the ostium. Premature stimulation often resulted in greater separation of the atrial and pulmonary vein potentials recorded within the pulmonary veins, fractionation of the pulmonary vein potentials, a change in the circumferential activation sequence of the pulmonary vein potentials, and dropout of pulmonary vein potentials.Conclusion: In response to premature stimulation, the muscle fascicles within the myocardial sleeves that surround the pulmonary veins display a greater degree of decremental conduction than do the myocardial fibers in the adjacent left atrium, and they display heterogeneity in conduction properties and refractoriness. Discrimination of pulmonary vein potentials from atrial electrograms is facilitated by premature stimulation.