[AF-FORUM] 14偶联的房性期前收缩 Uchida医生：

[AF Symposium]

非常高兴能在这次世界范围的重要心血管大会里遇到 
一位巴西同事。对于以上提到的孤立性（或特发性） 
房颤，房性期前收缩伴短暂偶联是较常见的，房早频 
繁发作并且诱发房性心动过速，最后转变成房颤。正 
如我们所知，这种期前收缩起源于肺静脉，最终由局 
部病灶诱发阵发性房颤。有一篇由Shan等人提供的文 
章，非常有趣，尽管是小样本文章，文章提出尽管无 
基础性心脏病，肥胖的人经常会有房早发作，并发展 
成房颤，这种现象可能是心房应激。Dr.Sidney Campodonico  
Filho（巴西）

Dr. Sergio Dubner科委会主席
Dr. Edgardo Schapachnik组委会主席 来自巴西的

Augusto Uchida医生问：运动后的房性期前收缩预示房颤 
的发生吗？ 来自希腊的Polychronis Dilaveris医生回答： 
我对问题“运动后的房性期前收缩预示房颤的发生 
吗？”的回答是：文献里关于运动后房早是否能预示 
房颤的文章很有限。只有一篇以前的研究文章 
(Folkeringa RJ, et al. Heart 2006;92:545-6)表明运动后的房早 
对于左室肥厚的患者来说提示将来患房颤的高危险 
性。很明显房早会发生在运动之中或之后，原因是心 
房牵张，尤其是左室肥厚和舒张功能受限的患者。运 
动试验之中或之后发生的房早与随之发生的房颤有 
关，这是常识。然而，这篇最新报告将运动后的房早 
与发展成长期房颤联系起来（时间长于40月的随 
访）。这篇文章的作者预测运动试验之后早期恢复阶 
段人自主神经功能异常，与未来的房颤发生有关，这 
种预测机制是否能被将来的试验所证实仍然是一个问 
题。Chronis                                                   邸 
亚丽译


Dear Dr. Uchida,I am very happy of having found a Brazilian colleague  
in this  magnificent world meeting of cardiology.In the mentioned  
forms of isolated (or idiopathic) AF, the presence  of premature  
atrial contractions with very short coupling is common,  occurring  
frequently and in runs of atrial tachycardias, and often  times,  
degenerating into AF.As we all know, these premature contractions  
originate within the  pulmonary veins and eventually they start  
paroxysmal AF episodes with focal origin.There is also a paper  
presented by Shan et al, very interesting, although with a very small  
sample, which showed that obese  individuals that are carriers of  
frequent premature atrial contractions, without basic heart disease,  
developed fibrillatory episodes, maybe by atrial stress.
Best regards,
Dr.Sidney Campodonico Filho(Brazil)

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee

 > Dr. Augusto Uchida from Brazil asks> -  Atrial extrasystoles after  
exercise can predict atrial   fibrillation ?
 > Dr. Polychronis Dilaveris from Greece answers-
My answer to the question: "Atrial extrasystoles after exercise can  
predict atrial fibrillation ?" is: There are limited data on the  
literature concerning the ability of post-exercise atrial  
extrasystoles to predict atrial fibrillation. Only one previous study  
(Folkeringa RJ, et al. Heart 2006;92:545-6) showed that atrial  
extrasystoles after exercise convey a high risk of future atrial  
fibrillation in patients with left ventricular hypertrophy. It is  
obvious that atrial extrasystoles may occur during or shortly after  
exercise as a result of acute atrial stretch, especially in patients  
with left ventricular hypertrophy and diastolic dysfunction. It is  
common knowledge that the appearance of such atrial extrasystoles  
during exercise testing can be associated with the development of  
atrial fibrillation episodes during or immediately after the exercise  
test. However, this recent report associated the appearance of post- 
exercise atrial extrasystoles with the development of atrial  
fibrillation in the long- term  (mean follow-up longer than 40  
months). The authors of this study speculated that the presence of  
autonomic dysfunction, that was exposed in the early recovery period  
after the exercise testing, underlined the development of future  
atrial fibrillation episodes. whether this speculative mechanism will  
be proven in future studies is still questionned.

Best regards,
 > Chronis


--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee