Studies of Atrial Fibrillation in Patients

描述(由申请人提供)：这项拟议研究的两个广泛的、长期的目标是使用电生理技术来提高我们对患者心房颤动(AF)的机制的理解，并为其治疗开发更好的基础。本研究计划的具体目的是研究患者1)在心内直视手术期间，a)在两个心房同时进行心房激动的顺序；i)在各种类型(阵发性、持续性或永久性)和持续时间(最近发生、周、月或年)的自发性房颤期间；ii)在房颤期间超速起搏或在接近或在极短周期长度的规则节律区域内的一个或多个部位进行程序性心房刺激；iii)在房颤转复为窦性心律后；iv)在有或没有房颤病史的患者中，在窦性心律期间从选定的房颤部位进行心房起搏；B)在房颤期间，识别和表征周期长度非常规则但非常短的区域，被认为是驱动心房产生纤颤传导的区域；c)在不同形式和持续时间的房颤患者中，从两个心房中选定的部位表征窦性心律期间的心房有效不应期，并与正常心房和无房颤病史的患者进行比较；以及d)对术中激活标测期间记录的心房电信号进行快速傅立叶变换(FFT)分析，以识别和帮助描述具有极短周期长度的规则节律的区域的存在；2)在新发房颤患者术后使用临时心外膜导线电极；a)记录心房电信号，并对这些心房电信号进行FFT分析，以识别和帮助确定是否存在极短周期的规则节律；以及b)从表现出极短周期长度的规则节律的区域进行超速起搏，试图终止房颤。

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.