Overdrive suppressionにおける洞結節―心房間伝導能の評価―洞結節電位による検討
Overdrive suppression (ODS) における洞結節一心房間伝導能の問題を検討する目的で洞電位記録法を用い, 洞機能正常者および洞機能不全症候群 (SSS) においてODS後の洞房伝導時間 (SACT) の変化を調べ (検討A) , さらに, SSSの症例で薬理学的除神経によるSACTの変化がODSにおよぼす影響について検討した (検討B) .洞機能正常者では洞周期長 (SCL) とSAOTは正相関を示したが, SSSでは相関はなかった.また, ODSによりSACTは洞機能正常者およびSSSともに有意に延長し, その延長率 (%ΔSACT) は洞調律時のSACTと負の相関を示...
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| Published in | 心電図 Vol. 16; no. 4; pp. 351 - 359 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本不整脈心電学会
25.07.1996
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0285-1660 1884-2437 |
| DOI | 10.5105/jse.16.351 |
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| Abstract | Overdrive suppression (ODS) における洞結節一心房間伝導能の問題を検討する目的で洞電位記録法を用い, 洞機能正常者および洞機能不全症候群 (SSS) においてODS後の洞房伝導時間 (SACT) の変化を調べ (検討A) , さらに, SSSの症例で薬理学的除神経によるSACTの変化がODSにおよぼす影響について検討した (検討B) .洞機能正常者では洞周期長 (SCL) とSAOTは正相関を示したが, SSSでは相関はなかった.また, ODSによりSACTは洞機能正常者およびSSSともに有意に延長し, その延長率 (%ΔSACT) は洞調律時のSACTと負の相関を示した.さらに, ABによる検討では, SACTと最長の洞結節回復時間が得られたときの刺激周期長のAB後の変化率 (%△POLp) は有意な相関を示した.この結果より, 洞結節への刺激の到達頻度は洞結節一心房間伝導能により規定され, SACTによりODSの効果を予想し得ると考えられた. |
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| AbstractList | Overdrive suppression (ODS) における洞結節一心房間伝導能の問題を検討する目的で洞電位記録法を用い, 洞機能正常者および洞機能不全症候群 (SSS) においてODS後の洞房伝導時間 (SACT) の変化を調べ (検討A) , さらに, SSSの症例で薬理学的除神経によるSACTの変化がODSにおよぼす影響について検討した (検討B) .洞機能正常者では洞周期長 (SCL) とSAOTは正相関を示したが, SSSでは相関はなかった.また, ODSによりSACTは洞機能正常者およびSSSともに有意に延長し, その延長率 (%ΔSACT) は洞調律時のSACTと負の相関を示した.さらに, ABによる検討では, SACTと最長の洞結節回復時間が得られたときの刺激周期長のAB後の変化率 (%△POLp) は有意な相関を示した.この結果より, 洞結節への刺激の到達頻度は洞結節一心房間伝導能により規定され, SACTによりODSの効果を予想し得ると考えられた. |
| Author | 津川, 博一 金山, 寿賀子 保志場, 八千代 宮本, 正哉 前田, 俊彦 村上, 暎二 竹越, 襄 太田, 克久 |
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| References | 17) Steinbeck G, Allessie MA, Bonke FIM, Lammers WJEP : Sinus node responce to premature atrial stmulation in the rabbit: studied with multiple microelectrode impalements. Circ Res 43: 695, 1978 4) Hariman RJ, Krongrad E, Boxer RA, Weiss MB, Steeg CN, Hoffman BF : Method for recording electrical activity of the sinoatrial node and automatic atrial foci during cardiac catheterization in human subjects. Am J Cardiol 45 : 775, 1980 1) Cramer M, Siegal M, Bigger JT, Hoffman BF : characteristics of extracellular potentials recorded from the sinoatrial pacemaker of the rabbit. Circ Res 41 : 292, 1977 6) Gomes JAC, Kang PS, El-Sherrif N : The sinus node electrogram in patients with and without sick sinus syndrome: Techniques and correlation between directly measured and indirectly estimated sinoatrial conduction time. Circulation 66 : 864, 1982 13) Furchgott RF, deGubareff T, Grossman A : Release of autonomic mediators in cardiac tissue by suprath-reshold stimulation. Science 129 : 328, 1959 2) Cramer M, Siegal M, Bigger JT, Hoffman BF Electrograms from the canine sino-atrial pacemaker recorded in vitro and insitu. Am J Cardiol 42 : 939, 1978 3) Hariman RJ, Krongrad E, Boxer RA, Bowman FO Jr, Mohn JR, Hoffman BF : Methods for recording electrograms of the sinoatrial node during cardiac surgery in man. Circulation 61 : 1024, 1980 9) Gomes JA, Hariman RI, Chowdry IA : New application of direct sinus node recordings in man: assessment of sinus node recovery time. Circulation 70: 663, 1984 15) Kodama I, Goto J, Ando S, Toyama J, Yamada K : Effects of rapid stimulation on the transmembrane action potentials of rabbit sinus node pacemaker cells. Circ Res 46: 90, 1980 8) Asseman P, Berzin B, Desry D, Vilaren D, Durand P, Delmotte C, Sarkis EH, Lekieffre J, Thery C Persistent sinus nodal electrograms during abnormally prolonged postpacing atrial pauses in sick sinus syndrome in humans: sinoatrial block vs overdrive suppression. Circulation 68 : 33, 1983 10) Amory DW, West TC : Chronotropic response following direct electrical stimulation of the isolated sinoatrial node : A pharmacologic evaluation. J Pharmacol Exp Ther 137 : 14, 1962 14) Lu, HH, Lange G, Brooks CMC : Factors control-ling pacemaker action in cells of the sinoatrial node. Circ Res 17: 460, 1965 7) 宮本正哉, 村上暎二, 竹越襄, 藤田静, 津川博一, 前田俊彦, 宮川松剛: 洞電位直接記録法による過駆動後の洞房伝導時間の変化についての検討. 心電図12 : 292, 1992 11) Vincenzi FF, West TC : Release of autonomic mediators in cardiac tissue by direct subthreshold electrical stimulation. J Pharmacol Exp Ther 141: 185, 1963 16) Miller HC, Strauss HC : Measurement of sinoatrial conduction time by premature atrial stimulation in the rabbit. Circ Res 35: 935, 1974 5) Haberl RH, Steinbeck G, Luderitz B : Comparison between intracellular and extracellular direct current recordings of sinus node activity for evaluation of sinoatrial conduction time. Circulation 70 : 760, 1984 12) Hutter OF, TRautwein W : Vagal and sympathetic affects on the pacemaker fibers in the sinus venosus of the heart. J Gen Physiol 39 : 715, 1956 |
| References_xml | – reference: 5) Haberl RH, Steinbeck G, Luderitz B : Comparison between intracellular and extracellular direct current recordings of sinus node activity for evaluation of sinoatrial conduction time. Circulation 70 : 760, 1984 – reference: 11) Vincenzi FF, West TC : Release of autonomic mediators in cardiac tissue by direct subthreshold electrical stimulation. J Pharmacol Exp Ther 141: 185, 1963 – reference: 15) Kodama I, Goto J, Ando S, Toyama J, Yamada K : Effects of rapid stimulation on the transmembrane action potentials of rabbit sinus node pacemaker cells. Circ Res 46: 90, 1980 – reference: 4) Hariman RJ, Krongrad E, Boxer RA, Weiss MB, Steeg CN, Hoffman BF : Method for recording electrical activity of the sinoatrial node and automatic atrial foci during cardiac catheterization in human subjects. Am J Cardiol 45 : 775, 1980 – reference: 13) Furchgott RF, deGubareff T, Grossman A : Release of autonomic mediators in cardiac tissue by suprath-reshold stimulation. Science 129 : 328, 1959 – reference: 9) Gomes JA, Hariman RI, Chowdry IA : New application of direct sinus node recordings in man: assessment of sinus node recovery time. Circulation 70: 663, 1984 – reference: 7) 宮本正哉, 村上暎二, 竹越襄, 藤田静, 津川博一, 前田俊彦, 宮川松剛: 洞電位直接記録法による過駆動後の洞房伝導時間の変化についての検討. 心電図12 : 292, 1992 – reference: 3) Hariman RJ, Krongrad E, Boxer RA, Bowman FO Jr, Mohn JR, Hoffman BF : Methods for recording electrograms of the sinoatrial node during cardiac surgery in man. Circulation 61 : 1024, 1980 – reference: 8) Asseman P, Berzin B, Desry D, Vilaren D, Durand P, Delmotte C, Sarkis EH, Lekieffre J, Thery C Persistent sinus nodal electrograms during abnormally prolonged postpacing atrial pauses in sick sinus syndrome in humans: sinoatrial block vs overdrive suppression. Circulation 68 : 33, 1983 – reference: 17) Steinbeck G, Allessie MA, Bonke FIM, Lammers WJEP : Sinus node responce to premature atrial stmulation in the rabbit: studied with multiple microelectrode impalements. Circ Res 43: 695, 1978 – reference: 10) Amory DW, West TC : Chronotropic response following direct electrical stimulation of the isolated sinoatrial node : A pharmacologic evaluation. J Pharmacol Exp Ther 137 : 14, 1962 – reference: 16) Miller HC, Strauss HC : Measurement of sinoatrial conduction time by premature atrial stimulation in the rabbit. Circ Res 35: 935, 1974 – reference: 12) Hutter OF, TRautwein W : Vagal and sympathetic affects on the pacemaker fibers in the sinus venosus of the heart. J Gen Physiol 39 : 715, 1956 – reference: 2) Cramer M, Siegal M, Bigger JT, Hoffman BF Electrograms from the canine sino-atrial pacemaker recorded in vitro and insitu. Am J Cardiol 42 : 939, 1978 – reference: 1) Cramer M, Siegal M, Bigger JT, Hoffman BF : characteristics of extracellular potentials recorded from the sinoatrial pacemaker of the rabbit. Circ Res 41 : 292, 1977 – reference: 6) Gomes JAC, Kang PS, El-Sherrif N : The sinus node electrogram in patients with and without sick sinus syndrome: Techniques and correlation between directly measured and indirectly estimated sinoatrial conduction time. Circulation 66 : 864, 1982 – reference: 14) Lu, HH, Lange G, Brooks CMC : Factors control-ling pacemaker action in cells of the sinoatrial node. Circ Res 17: 460, 1965 |
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| SubjectTerms | 洞房伝導時間 洞結節回復時間 洞結節電位 |
| Title | Overdrive suppressionにおける洞結節―心房間伝導能の評価―洞結節電位による検討 |
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