Role of atrial electrophysiology and autonomic nervous system in patients with supraventricular tachycardia and paroxysmal atrial fibrillation

Yi Jen Chen, Shih Ann Chen, Ching Tai Tai, Zu Chin Wen, An Ning Feng, Yu An Ding, Mau Song Chang

研究成果: 雜誌貢獻文章同行評審

121 引文 斯高帕斯(Scopus)

摘要

Objectives. The purposes of this study were to evaluate the atrial electrophysiology and autonomic nervous system in patients who had paroxysmal supraventricular tachycardia (PSVT) associated with paroxysmal atrial fibrillation (PAF). Background. PAF frequently appeared in patients with PSVT. However, the critical determinants for the occurrence of PAF were not clear. Methods. This study population consisted of 50 patients who had PSVT with (n = 23) and without (n = 27) PAF. Atrial pressure, atrial size, atrial effective refractory periods (AERPs), and AERP dispersion were evaluated during baseline and PSVT, respectively. Twenty-four hour heart rate variability and baroreflex sensitivity (BRS) were also examined. Results. There was greater baseline AERP dispersion in patients with PAF than in those without PAF. The atrial pressure, atrial size, AERPs in the right posterolateral atrium and distal coronary sinus, and AERP dispersion were increased during PSVT as compared with those during baseline. Patients with PAF had greater AERP dispersion than those without PAF during PSVT. The differences of atrial size, right posterolateral AERP, and AERP dispersion between baseline and PSVT were greater in patients with PAF than in those without PAF. BRS, but not heart rate variability, was higher in patients with PAF than in those without PAF. Univariate analysis showed that higher BRS (>4.5 ms/mm Hg, p = 0.0002, odds ratio = 16.1), AERP dispersion during PSVT (>40 ms, p = 0.0008, odds ratio = 9.7), and increase of right atrial area during PSVT (>2 cm2, p = 0.016, odds ratio = 10.7) were significantly correlated with the occurrence of PAF in patients with PSVT. Conclusions. Disturbed atrial electrophysiology and higher vagal reflex could play important roles in the genesis of PAF in patients with PSVT.

原文英語
頁(從 - 到)732-738
頁數7
期刊Journal of the American College of Cardiology
32
發行號3
DOIs
出版狀態已發佈 - 九月 1998

ASJC Scopus subject areas

  • Nursing(all)

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