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目的探讨无创性经食管信号平均技术直接记录窦房结电位(SNP)的方法。方法采用自制三导心电微电位检测仪对256例窦房结功能正常者进行检测,其中男142例,女114例,年龄10～74(44.2±12.4)岁。将食管导联的信号放大(增益达到100μV/cm)、滤波(0.1～50)Hz,16位模/数(A/D)转换,系统采样频率2kHz,对食管SNP进行信号平均,并通过同步信号平均对人食管和心内膜所记录的SNP,犬食管和心外膜所记录的SNP进行分析研究。结果记录到食管SNP189例(74%),所测信号平均食管SNP为P波前的低幅、低频波,可见有2种形态:园顶型(60%)和上斜型(40%);窦房传导时间为(83.3±26.7)ms,分布范围为(23～118)ms;波幅为(3.5～27.7)μV;dv/dt为(0.43～1.93)mV/s。结论在适当滤波、高增益和抗基线漂移技术条件下,利用经食管信号平均技术,大多数窦房结功能正常的患者可直接记录到食管SNP。
Objective To investigate the method of non-invasive transthoracic signal averaging (SNP) recording technique. Methods Two hundred and sixty-six cases with normal function of sino-atrial node were detected by self-made three-wire electrophorogram detector, including 142 males and 114 females, aged from 10 to 74 (44.2 ± 12.4) years. The signal of the esophageal lead was amplified (gain up to 100μV / cm), filtered (0.1 ~ 50) Hz, 16-bit A / D converted and the system sampling frequency was 2kHz. The signal averaged the SNP recorded in human esophagus and endocardium, and the SNP recorded in the esophagus and epicardium of dogs. RESULTS: The SNP of esophageal SNP was recorded in 189 cases of esophageal SNP (74%). The average esophageal SNP of the measured signal was low amplitude and low frequency wave of P wavefront. There were two kinds of morphological changes: the top of the tree (60%) and the upward slope (40%); The conduction time of the sinoatrial was (83.3 ± 26.7) ms and the distribution range was (23 ~ 118) ms. The amplitude was (3.5-27.7) μV and the dv / dt was 0.43-1.93 mV / s. Conclusions With proper filtering, high gain and anti-baseline drift techniques, the majority of patients with normal sinus node function can record esophageal SNP using transesophageal signal averaging techniques.