P Wave and the Substrates of Arrhythmias Originating intheAtria.
P Wave and the Substrates of Arrhythmias Originating intheAtria.
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DOI：
10.1016/j.ccep.2017.05.001
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发表时间：
2017-09-01
影响因子：
--
通讯作者：
Padeletti, Luigi
中科院分区：
文献类型：
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作者：
Bagliani, Giuseppe;Leonelli, Fabio;Padeletti, Luigi
窦房结是主要的心脏起搏器，激动的波前从窦房结通过心房纤维束到达房室结。左心房激动沿着Bachmann束和右心房下部进行，确定P波形态。心电图显示异位或逆行性心房激动、游走性起搏器活动或人工起搏器介导的心房去极化。心向量描记术和经食管记录是互补的方法。心房解剖结构和窦房结外的自律细胞构成了局灶性和折返性房性心律失常的机制。具有特定致心律失常机制的心律失常对应于准确诊断的精确心电图形态。
The sinus node is the primary cardiac pacemaker from which the wavefront of activation proceeds through bundles of atrial fibers to the atrioventricular node. Left atrial activation proceeds along the Bachmann bundle and lower right atrium, determining P-wave morphology. Electrocardiogram reveals ectopic or retrograde atrial activation, wandering pacemaker activity, or artificial pacemaker-mediated atrial depolarization. Vectorcardiography and transesophageal recording are complementary methods. Atrial anatomic structure and automatic cells outside the sinus node constitute the mechanisms of focal and reentrant atrial arrhythmias. Arrhythmias with specific arrhythmogenic mechanisms correspond to precise electrocardiographic morphology for accurate diagnosis.