Key result
In human atria, the initiation of atrial fibrillation is associated with shortened refractory periods and wavelength, while chronic atrial fibrillation involves further wavelength shortening due to enhanced conduction delay and atrial enlargement.
Cross-Sectional (n=50)
In human atrial muscle, shortening of the repolarization phase, conduction delay, and atrial enlargement all shorten the wavelength, facilitating the initiation and maintenance of atrial fibrillation.
Supports wavelength shortening as AF substrate in human atria; hypothesis-generating and should not yet change practice.
洞不全症候群を除く50症例を, 一過性心房細動 (一過性af) の誘発ができない20例と誘発のできる14例, 及び, 1ヵ月以上持続した慢性afに対して電気的除細動を施行した16例に分類し, 心房筋再分極の指標 (右房有効不応期ERP, 右房単相性活動電位持続時間MAP口90) , 伝導遅延の指標 (右房内局所最大伝導遅延率%CD) , wavelengthの指標 (MAPD90/%CD, ERP/%CD) , 右心房容積の指標 (心臓超音波検査による右房心内膜トレース/体表面積) を, それぞれ計測した.この結果, 一過性afの誘発には再分極相の短縮とそれによるwavelengthの短縮が関与し, 慢性afでは再分極相の短縮に加え, 増強した伝導遅延によりwavelengthはさらに短縮していた.また, 心房が拡大するとwavelengthは短縮した.この様に, ヒト心房筋において再分極相の短縮, 伝導遅延, 心房拡大はいずれもwavelengthを短縮し, afを発生, 持続させ易くすると考えられた.
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Shinozaki et al. (1998) conducted a cross-sectional in Atrial Fibrillation (n=50). Atrial fibrillation status (chronic, induced, or non-inducible) vs. Non-inducible atrial fibrillation (NPAF) was evaluated on Atrial wavelength indices (WLa and WLe) derived from refractory period and conduction delay. In human atria, the initiation of atrial fibrillation is associated with shortened refractory periods and wavelength, while chronic atrial fibrillation involves further wavelength shortening due to enhanced conduction delay and atrial enlargement.
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