| Project/Area Number |
60480234
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Circulatory organs internal medicine
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| Research Institution | Nakasaki University |
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Principal Investigator |
HASHIBA Kunitake Nagasaki Univ. School of Med., Professor, 医学部, 教授 (40039483)
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| Co-Investigator(Kenkyū-buntansha) |
YANO Katsusuke nagasaki Univ. School of Med., Assistant Professor, 医学部, 講師 (50039864)
KIYA Fumihiro Nagasaki Univ. School of Med., Medical Associate, 医学部, 助手 (20108301)
FUKATANI Masahiko Nagasaki Univ. School of Med., Assistant Professor, 医学部, 講師 (70039551)
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| Project Period (FY) |
1985 – 1987
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| Project Status |
Completed (Fiscal Year 1987)
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| Budget Amount *help |
¥3,100,000 (Direct Cost: ¥3,100,000)
Fiscal Year 1987: ¥1,700,000 (Direct Cost: ¥1,700,000)
Fiscal Year 1986: ¥1,400,000 (Direct Cost: ¥1,400,000)
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| Keywords | dual A-V nodal pathways / 発作性上室性頻拍 / 経年的変化 / 臨床心臓電気生理検査 / 経食道心房ペーシング法 / 心房期外刺激法 / 房室結節リエントリー性頻拍 / 薬理学的自律神経遮断 / Ca拮抗薬 / 速伝導路 |
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| Research Abstract |
The dual A-V nodal pathways (DAVNPW) are one of the important mechanism of the paroxysmal supraventricular tachycardia (A-V modal reentrant tachycardia) and have been considered ad a functional longitudinal dissociation within the A-V node rather than anatomical abnormalities. The purpose of this study is to study the reproducibility of DAVNPW in a ong follow-up period to clarify the peroperties of DAVNPW and to study the electrophysiological determinants of A-V nodal reentry.
Subjects were 499 patients in whom electrophysiologic studies (EPS) were performed for various cardic arrhythmias between 1975 and 1984. DAVNPW were observed in 120 (24.0%) of the 499 patients. The electrophysiological properties of antegrade and retrograde pathways of DAVNPW were analyzed in 54 of the 120 patients. The A-V nodal reentrtant tachycardia was induced more frequently in patients in whom both antegrade and retrograde Wenckebach points were 150 neats/min or more. In 18 out of the 120 patients with DAVNPW the 2nd EPS was performed using moninvasive transesophageal pacing method. DAVNPW were reconfirmed to exist in 16 (88.9%) of 1, patients after 6 - 104 (average 40) months of the initial EPS. The width of jump from the fast to slow pathways, and ERP and FRP of the fast and slow pathways in the 2nd study were significantly correlated with those in the 1st study, respectively.
These results suggest that DAVNPW might be more likely related to some structural rather than purely functional abnormalities and that patients with excellent conductivity both antegrade slow pathway and in retrograde fast pathway are more likely to have A-V nodal reentrant tachycardia.
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