長く続く心房細動によって引き起こされる電気生理学的変化は,逆戻り可能なのでしょうか? : atrial defibrillatorを使用した観察結果
L M Rodriguez1, C Timmermans, H J Wellens
1Department of Cardiology, Academic Hospital, Maastricht, The Netherlands. L.M.Rodriguez@cardio.azm.nl
Circulation
|July 14, 1999
まとめ
心房細動 (AF) は,長年のAF歴のあるほとんどの患者で,長時間シヌスリズムが続いた後も誘導可能であり続けました. 心房の電気生理学は正常化せず,治療が成功しても変化が持続することを示した.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 心律不整症とは,心律不整症のこと.
背景:
- 動物の研究は,長時間動 (AF) が動の有効耐火期 (AERP) を変化させることを示唆しています.
- 人における心房電気生理学に対する長期的なAFの影響については,さらなる調査が必要である.
研究 の 目的:
- Metrix Atrioverterで治療された長期にわたる再発性AFの患者で,延長されたシヌスリズム後の心房電気生理学を評価する.
- AF再発とシヌスリズム持続時間に対する迅速な心転移の影響を分析する.
主な方法:
- エレクトロ生理学的研究は,アトリオーバーター植入後の再発性AF (3~21年持続) の4人の患者に実施されました.
- アトリアル有効耐火期 (AERP) は,インプランテーション前と >1000時間のシナウスリズム後に測定されました.
- 心房細動 (AF) の誘導性は,単一の心房早拍を用いて評価されました.
主要な成果:
- AFは,長時間シヌスリズム (>1000時間) を経った4人の患者のうち3人の1つの心房早拍で誘導され続けました.
- 1人の患者では,AFは誘導されず,AERPの測定値は移植前の値に類似していました.
- 長期にわたる再発性AFの病歴のある患者では,心房電気生理学的正常化は観察されなかった.
結論:
- 長期にわたる再発性AFは,心房の持続的な電気生理学的変化につながります.
- アトリヤの電気生理学は,長期間シヌスリズムとAF治療に成功した後でも,正常なパターンに完全に回復しません.
- 単一の早拍でAFの誘導性は,長年のAF歴のある患者の大半に持続します.
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