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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Unipolar waveforms and monophasic action potentials in the characterization of slow conduction in human atrial flutter.
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Unipolar waveforms and monophasic action potentials in the characterization of slow conduction in human atrial flutter.

机译：单极波形和单相动作电位可表征人心房扑动的缓慢传导。

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Anisotropic propagation may be involved in the development of areas of slow conduction in atrial flutter. We evaluated monophasic action potentials (MAPs) and simultaneous unipolar (0.2-400 Hz) and bipolar electrograms from multiple atrial sites of patients undergoing RF ablation of idiopathic atrial flutter. Nine patients (mean age 46 +/- 20 years) with typical atrial flutter (one with both types) were studied. Unipolar electrograms with triphasic complexes of small amplitude and with a slow, negative deviation of the baseline preceding the rS deflection indicated transversal conduction in relation to the orientation of cardiac fibers; smooth rS complexes longitudinal conduction; QS complexes onset of activation; and R complexes end of activation or collision. In all patients with typical atrial flutter, slow conduction occurred in the corridor between the inferior vena cava, the tricuspid annulus, and the coronary sinus. Transversal conduction was observed in this area, whereas the remaining sites showed longitudinal conduction. Anatomically guided RF ablation was successful in five patients. Transversal conduction was recorded in all successful sites. In the patient with atypical atrial flutter, slow conduction was noted in the high lateral right atrium, also exhibiting transversal conduction. Ablation at this area terminated the arrhythmia. All the areas of transversal conduction during flutter displayed longitudinal conduction after restoration of sinus rhythm. MAPs were normal in all patients during atrial flutter and sinus rhythm, even at the areas where transversal conduction was recorded. These findings suggest that anisotropic propagation is involved in the genesis of functionally determined areas of slow conduction during typical atrial flutter.
机译：房颤慢传导区域的发展可能涉及各向异性传播。我们评估了自发性房扑的射频消融患者的多个心房部位的单相动作电位（MAPs）以及同时的单极（0.2-400 Hz）和双极电描记图。研究了9例典型的心房扑动（平均年龄为46 +/- 20岁）（两种类型中的一种）。在rS偏转之前，具有三相振幅小且基线缓慢，负偏差的单极电描记图表明相对于心脏纤维方向的横向传导;平滑的rs复合物纵向传导; QS复合物开始活化;和R配合物终止活化或碰撞。在所有典型的房扑患者中，下腔静脉，三尖瓣环和冠状窦之间的通道中发生缓慢的传导。在该区域观察到横向传导，而其余部位显示纵向传导。解剖学指导的射频消融成功治疗了五例患者。在所有成功的部位均记录了横向传导。在具有非典型房扑的患者中，在右外侧心房高处观察到传导缓慢，并且还表现出横向传导。在该区域消融终止了心律不齐。恢复窦性心律后，扑动过程中的所有横向传导区域均表现为纵向传导。在心房扑动和窦性心律期间，所有患者的MAP均正常，即使在记录横向传导的区域也是如此。这些发现表明，在典型的心房扑动过程中，各向异性传播与功能决定的慢传导区域的发生有关。

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