Fragmented atrial activity in patients with transient atrial fibrillation.
Fragmented atrial activity in patients with transient atrial fibrillation.
复制标题
短暂性心房颤动患者的心房活动不完整。
DOI：
10.1016/0002-8703(91)90956-i
复制
发表时间：
1991
影响因子：
4.8
通讯作者：
Y. Aizawa
中科院分区：
文献类型：
--
作者：
S. Niwano;Y. Aizawa
Prediction of atrial fibrillation (AF) is very important in patients with Wolff-Parkinson-White syndrome or in the selection of pacemaker therapeutic modality. In 25 patients with transient AF, the response of the atrial activity width to extrastimuli was examined in comparison with 25 patients without AF to see if the results could be used as an index of subsequent occurrence of AF. Programmed electrical stimulation using eight basic stimuli followed by single or double extrastimuli (P1P2or P1P2P3) were delivered to the high right atrium, and the atrial activities were examined. The prolongation of the atrial activity caused by extrastimuli was termed fragmentation (Frg), and it was defined as the prolongation of more than 150% of the basic stimuli. Frg zone was defined as the zone of coupling intervals of the extrastimuli (P1P2or P2P3) that caused Frg, andΔmax Frg was defined as the difference between the widest Frg and the atrial wave width during basic stimuli. Fragmentation was reproducibly induced by extrastimuli, and there was an inverse relationship between Frg duration and the coupling interval of the extrastimuli (P1P2or P2P3). Frg zone andΔmax Frg were wider and longer in patients with transient AF in comparison with the control group for both single and double extrastimuli (p< 0.001). AF inducibility using double extrastimuli was significantly high in patients with AF. The Frg zone for P2and P3were 72 ± 44 msec and 82 ± 37 msec in the AF group and 11 ± 15 msec and 16 ± 13 msec in the non-AF group, respectively. TheΔmax Frg for P2and P3were 82 ± 31 msec and 100 ± 26 msec in the AF group and 27 ± 15 msec and 33 ± 13 msec in the non-AF group, respectively. Clinical occurrence of AF can be predicted by these electrophysiologic parameters using the following criteria: (1) Frg zone is beyond 50 msec or (2)Δmax Frg is beyond 70 msec. Our results achieved a sensitivity of 96%, a specificity of 96%, and a predictive value of 96%. Frg may express a local conduction delay of the atrium and even spontaneous premature beats may lead to an AF attack. Electrophysiologic study may be useful to disclose such a local conduction delay.
