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目的:对风湿性心脏病(风心病)慢性心房颤动(房颤)的房波电振幅特点进行研究,以探讨其在房颤产生和持续中的意义。方法:选择44例风心病慢性房颤患者在术前作16导左、右房同步心外膜标测图并进行分析,同时与10 例室上速(对照组)心内电生理检查结果进行比较。结果:风心病慢性房颤患者A波,左房后壁中、下部f波振幅明显低于对照组A波,左房后壁上、中、下部位f波振幅明显低于右房(P<0.05)。14 例房颤电复律后心房各部位的A波幅明显大于术前f波振幅(P<0.01),左心耳f波振幅显著大于左房后壁上、中、下部,左房后壁上部f波振幅显著大于左房后壁中部。风心病慢性房颤患者f波振幅与心房内径和容积无相关。结论: 左房后壁中、下部f波振幅最低,在左房心耳、左房上和左房中、下部之间存在明显电位差,提示左房中、下部是最易产生各向异性传导的部位,推测为AF起源,在明显电位差的部位易形成折返环。
OBJECTIVE: To study the characteristics of atrial-wave amplitude amplitude of chronic atrial fibrillation (AF) in patients with rheumatic heart disease (rheumatic heart disease) and to explore its significance in the occurrence and persistence of atrial fibrillation. Methods: Forty-four patients with chronic atrial fibrillation who underwent atrial fibrillation were enrolled in this study. Sixteen cases of left atrial and right atrial synchronic epicardium were selected and analyzed. The results of electrophysiological examination in 10 cases of supraventricular tachycardia (control group) Compare Results: The amplitude of f wave in middle and lower part of A wave and left posterior wall in patients with rheumatic heart disease was significantly lower than that in control group. The amplitude of f wave in the upper, middle and lower posterior wall of left atrium was significantly lower than that in right atrium (P < 0.05). The amplitude of A wave in atrial fibrillation was significantly greater in all 14 atrial fibrillation AF patients than that in preoperative atrial fibrillation (P <0.01). The amplitude of left atrial f wave in left atrial appendage was significantly larger than that in the upper left posterior wall Wave amplitude was significantly larger than the posterior wall of the left atrium. There was no correlation between the amplitude of f-wave and the diameter and volume of atria in patients with rheumatic heart disease. Conclusion: The left and right posterior wall of the f-wave amplitude of the bottom of the lowest in the left atrial appendage, left atrial and left atrial there is a significant potential difference between the lower part of the left, suggesting that the left atrium is the most likely to produce anisotropic conduction Site, presumed to be the origin of AF, easy to form reentrant ring in the site of obvious potential difference.