心房内刺戟傳導に關する實驗的研究(第3報) : 家兎心房の刺戟傳導に就て

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Using rabbit's heart unipolar leads E. C. G. were taken simultaneously over the intra vena cava superior of its initial region and the atrial surface, and calculated the time of activation arrival at different points on the atrial surface, at the same time observing the morphology of the P wave on the E. C. G. led from the surface of the atria.Summary and conclusion of this study are as follows : 1) The form of the P wave in the unipolar lead E. C. G. led from the superior cava venous appendage's angle indicated a negative wave of the QS type and the activation arrival at this point was found to be the earliest point of all on the atrial surface, which made one to assume that this region must be the initial point of activation.2) The activation arrival at points lying along the taenia terminalis from the venous appendage's angle (above mentioned) downward to the right was rapid compared with those at other points on the atrium. Moreover, the form of the P wave at these points in the unipolar lead E. C. G. was found to be of the rS type with predominance of the negativity.3) Despite the fact that the distance between each points on the surface of the right appendage and the head of the sinus node was comparatively small, the activation arrival was late, and the P wave in the unipolar lead E. C. G. taken over those points indicated the RS type.4) Inferring from above facts and the activation times at various points on the atrial surface, it is proper to acknowledge the assumption that the activation of the atrium does not propagate from the head of the sinus node in proportion to distance in diffusiveness, but is carried out through some definite formation.II. In experiments with eight rabbits, the author recorded the E. C. G. intra atrial unipolar lead and the standard limb lead II simultaneously after injuring different points at localities in the atrial wall and the atrial septum thrusting them with a pointed knife through the atrial wall or the appendage, and studied how relationships are there between the injured points and the change in the E. C. G. Various observation were made on the different injured points. Summary and conclusion of this experiment are as follows : 1) When the previous part of the fossa ovalis or wall of the appendage were injured, the heart beating remained for about 30 minutes, and besides a presumption of the results of an acute heart failure due to bleeding, no particular change was observed in the E. C. G.2) When injury was given to the upper part of the right atrium near the Bachmann's bundle, it was observed that very soon after the administering of injury changes were seen to take place, such as a marked transformation of the P wave, an irregular beating of the heart, an appearance of two P waves of entirely different kind, disturbances in the a-v conduction, etc. From these observation, it was assumed that there existed activation pathways between the sinus node and the left atrium, and between the sinus node and the Tawara's node.3) An injury given to the border between the anterior wall of the atrium and the septum often caused such changes in the E. C. G. as the shortening or prolongation of the P-Q interval, an appearance of the a-v nodal rhythm, a sudden cease of the heart beat, etc. From above observations it may be assumed that the stimulus conduction of the atria is not one rendered through complete diffusion but through some stimulus conduction pathways running directly from the sinus node to the right and left atria and the Tawara's node.
社団法人日本循環器学会の論文
1958-11-20

著者

西井憲夫
三重縣立大學醫學部内科教室

心房内刺戟傳導に關する實驗的研究(第3報) : 家兎心房の刺戟傳導に就て

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