Effect of atrioventricular interval during pacing or reciprocating tachycardia on atrial size, pressure, and refractory period. Contraction-excitation feedback in human atrium.
Effect of atrioventricular interval during pacing or reciprocating tachycardia on atrial size, pressure, and refractory period. Contraction-excitation feedback in human atrium.
复制标题
起搏或往复性心动过速期间房室间隔对心房大小、压力和不应期的影响。
DOI：
10.1161/01.cir.82.1.60
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发表时间：
1990
期刊：
影响因子：
37.8
通讯作者：
Zipes,DP
中科院分区：
文献类型：
--
作者：
Klein,LS;Miles,WM;Zipes,DP
为了确定人类心房中是否存在收缩-兴奋反馈机制，我们研究了 10 名患者（第 1 组，无室上性心动过速）在 400 毫秒周期长度的 AV 起搏期间将房室 (AV) 间隔从 0 更改为 360 毫秒对心房压力、大小和不应性的影响。在 AV 往复性心动过速或 AV 结往复性心动过速期间以及在心动过速周期长度的高右心房 (RA) 起搏期间，对另外 10 名患者（第 2 组，具有不同的自发 AV 关系）确定了相同的参数。在第 1 组患者中，RA 峰值压力和平均压力、RA 有效不应期 (RA-ERP) 和左心房 (LA) 大小均在 AV 间期为 120 毫秒时降至最小值，并在 AV 间期增加并接近 400 毫秒时保持较低水平。每个变量从最低值到最高值的增加如下： 平均全身血压，20.9 +/- 3.1 mm Hg； LA 尺寸，0.55 +/- 0.05 厘米； RA 峰值压力，10.4 +/- 1.8 mm Hg； RA 平均压力，3.5 +/- 0.6 毫米汞柱； RA-ERP，22.5 +/- 3.0 毫秒，p 均小于 0.001。 RA-ERP 的加权平均相关系数对于 RA 峰值压力和 LA 大小具有显着性（p 均小于 0.001）。在 5 名患有 Wolff-Parkinson-White 综合征和 AV 往复性心动过速的患者以及 5 名患有 AV 结往复性心动过速的患者（第 2 组）中研究了这些相同的关系。（摘要截断为 250 字）
To determine whether a contraction-excitation feedback mechanism exists in human atrium, we investigated the effects of varying the atrioventricular (AV) interval from 0 to 360 msec during AV pacing at a cycle length of 400 msec on atrial pressure, size, and refractoriness in 10 patients (group 1, without supraventricular tachycardia). The same parameters were determined in another 10 patients (group 2, with different spontaneous AV relations) during AV reciprocating tachycardia or AV nodal reciprocating tachycardia and during high right atrial (RA) pacing at the tachycardia cycle length. In group 1 patients, peak and mean RA pressure, RA effective refractory period (RA-ERP), and left atrial (LA) size all decreased to minimal values at an AV interval of 120 msec and remained low as the AV interval was increased and approached 400 msec. The increase in each of the variables from its lowest to greatest value was as follows: Mean systemic blood pressure, 20.9 +/- 3.1 mm Hg; LA size, 0.55 +/- 0.05 cm; RA peak pressure, 10.4 +/- 1.8 mm Hg; RA mean pressure, 3.5 +/- 0.6 mm Hg; and RA-ERP, 22.5 +/- 3.0 msec, p less than 0.001 for each. The weighted mean correlation coefficient with RA-ERP was significant for RA peak pressure and LA size (p less than 0.001 for each). These same relations were investigated in five patients with the Wolff-Parkinson-White syndrome and AV reciprocating tachycardia and five patients with AV nodal reciprocating tachycardia (group 2).(ABSTRACT TRUNCATED AT 250 WORDS)