Magnetophysiologic and echocardiographic comparison of blocked atrial bigeminy and 2:1 atrioventricular block in the fetus.
Magnetophysiologic and echocardiographic comparison of blocked atrial bigeminy and 2:1 atrioventricular block in the fetus.
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DOI：
10.1016/j.hrthm.2013.04.020
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发表时间：
2013-08
期刊：
影响因子：
5.5
通讯作者：
Wakai, Ronald T.
中科院分区：
文献类型：
--
作者：
Wiggins, Delonia L.;Strasburger, Janette F.;Gotteiner, Nina L.;Cuneo, Bettina;Wakai, Ronald T.
房室传导阻滞(BAB)和二度房室传导阻滞(2：1 AVB)均为室性心动过缓，超声心动图难以区分。由于这些节律的预后和临床处理不同，准确的诊断是至关重要的。确定能够可靠地区分BAB和2：1 AVB的磁性和机械性心率和节律参数。对10例BAB患者和7例2：1 AVB患者进行了胎心磁图(FMCG)和脉冲多普勒超声检查，以确定能可靠区分BAB和2：1 AVB的参数。用FMCG区分Bab和2：1 AVB相对简单，因为Bab的异位P波(P‘)出现较早，导致二元性(短-长)房性心律。异位搏动的标准化耦合间期(阻滞性搏动的PP‘与传导搏动的PP’)为0.29±0.03。相反，超声心动图对流入-流出的评价显示归一化机械耦合间期(Aa‘/Aa)接近0.5，这使得BAB和2：1 AVB难以区分。心率(82±5.7次/min比69±4.2次/min)与2：1房室传导速度(BAB与2：1 AVB)有明显区别，但不是一个完全可靠的指标。在大多数受试者中，Bab与窦性心律或其他节奏交替，导致复杂的心率和节律模式。超声心动图很难区分胎儿Bab和2：1房室传导阻滞，因为在许多Bab胎儿中，机械节律不能准确反映磁节律。FMCG为鉴别诊断提供了更可靠的手段。
Blocked atrial bigeminy (BAB) and second-degree atrioventricular block with 2:1 conduction block (2:1 AVB) both present as ventricular bradycardia and can be difficult to distinguish by echocardiography. Since the prognosis and clinical management of these rhythms are different, an accurate diagnosis is essential. To identify magnetic and mechanical heart rate and rhythm parameters that could reliably distinguish BAB from 2:1 AVB. A retrospective fetal magnetocardiography (fMCG) and pulsed Doppler ultrasound study of 10 subjects with BAB and 7 subjects with 2:1 AVB was performed in order to identify parameters that could reliably distinguish BAB from 2:1 AVB. Distinguishing BAB from 2:1 AVB by using fMCG was relatively straightforward because in BAB the ectopic P wave (P′) occurred early, resulting in a bigeminal (short-long) atrial rhythm. The normalized coupling interval of the ectopic beat (PP′ of the blocked beat to PP of the conducted beat) was 0.29 ± 0.03. In contrast, the echocardiographic assessment of inflow-outflow gave a normalized mechanical coupling interval (AA′/AA) near 0.5, which made it difficult to distinguish BAB from 2:1 AVB. Heart rate distinguished most subjects with BAB from those with 2:1 AVB (82 ± 5.7 beats/min vs 69 ± 4.2 beats/min), but was not a completely reliable indicator. In most subjects, BAB alternated with sinus rhythm or other rhythms, resulting in complex heart rate and rhythm patterns. Fetal BAB and 2:1 AV block can be difficult to distinguish using echocardiography because in many fetuses with BAB the mechanical rhythm does not accurately reflect the magnetic rhythm. fMCG provides a more reliable means of making a differential diagnosis.
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影响因子：
2.2
作者：
Mensah-Brown, Nana Aba;Wakai, Ronald T.;Strasburger, Janette F.
通讯作者：
Strasburger, Janette F.
影响因子：
2.8
作者：
Cuneo, BF;Ovadia, M;Wakai, RT
通讯作者：
Wakai, RT
影响因子：
3.6
作者：
Wyllie R;Kauer M;Wakai RT;Walker TG
通讯作者：
Walker TG
影响因子：
3.5
作者：
Zhao, H;Wakai, RT
通讯作者：
Wakai, RT
影响因子：
24
作者：
Zhao, Hui;Cuneo, Bettina F.;Wakai, Ronald T.
通讯作者：
Wakai, Ronald T.