Studies of Atrial Fibrillation in Patients

描述（由申请人提供）：本拟议研究的两个广泛的长期目标是使用电生理技术来提高我们对患者房颤（AF）机制的理解，并为其治疗奠定更好的基础。 本研究计划的具体目的是研究患者1）在心脏直视手术期间a）同时标测两个心房的心房激动顺序i）在各种类型的自发性AF期间（阵发性、持续性或永久性）和持续时间（最近发作，数周、数月或数年）; ii）在AF期间从接近于或在非常短周期长度的规则节律区域内的一个或多个部位的起搏或程控心房刺激期间; iii）在AF至窦性心律的心脏复律之后; iv）在具有或不具有AF病史的患者中，在窦性心律期间从所选心房部位进行心房起搏期间; B）在AF期间，识别和表征被认为驱动心房产生代偿性传导的非常规则但非常短的周期长度的区域;（3）观察不同形式和持续时间的房颤患者在窦性心律时心房有效不应期的特征，并与无房颤史的正常心房患者进行比较;以及d）获得快速傅立叶变换（FFT），分析术中激动标测期间记录的心房电描记图，以识别并帮助表征具有非常短周期长度的规则节律的区域的存在;和2）在术后期间，在新发AF患者中使用临时心房心外膜线电极a）记录心房电描记图并获得这些心房电描记图的FFT分析，以识别和帮助表征非常短周期长度的规则节律的存在;以及B）从表现出非常短周期长度的规则节律的区域执行快速起搏以尝试终止AF。

DESCRIPTION (provided by applicant): The two broad, long term objectives of this proposed research are to use electrophysiological techniques to improve our understanding of the mechanisms responsible for atrial fibrillation (AF) in patients and to develop an improved basis for its treatment. The specific aims of this research plan are to study patients 1) during open heart surgery a) to map the sequence of atrial activation simultaneously in both atria i) during spontaneous AF of various types (paroxysmal, persistent, or permanent) and duration (recent onset, weeks, months, or years); ii) during overdrive pacing or programmed atrial stimulation during AF from a site or sites close to or within an area of regular rhythm of very short cycle length; iii) following cardioversion of AF to sinus rhythm; iv) during atrial pacing from selected atrial sites during sinus rhythm in patients with or without a history of AF; b) during AF, to identify and characterize areas of very regular but very short cycle length, thought to drive the atria creating fibrillatory conduction; c) to characterize the atrial effective refractory period during sinus rhythm from selected sites in both atria in patients with various forms and durations of AF, and compare that with patients with normal atria and no history of AF; and d) to obtain Fast Fourier Transform (FFT) analysis of atrial electrograms recorded during intraoperative activation mapping to identify and help characterize the presence of a region with a regular rhythm of very short cycle length; and 2) in the postoperative period to use temporary atrial epicardial wire electrodes in patients with new onset AF a) to record atrial electrograms and obtain FFT analysis of these atrial electrograms to identify and help characterize the presence of a regular rhythm of very short cycle length; and b) to perform overdrive pacing from an area demonstrating a regular rhythm of very short cycle length to try to terminate the AF.