摘要
目的探讨房室结双径路"光滑"房室结功能曲线的本质。方法本组将房室结折返性心动过速(AVNRT)分成曲线光滑组(Ⅰ组)和曲线中断组(Ⅱ组),并设立对照组,进行组间和消融前后的比较分析,观察房室结功能曲线的变化。结果Ⅰ组术后房室结有效不应期(328±22 ms)较术前(306±24 ms)明显延长(P<0.05),心房起搏时最长 A_2H_2间期(205±65 ms)较术前(280±51 ms)明显缩短(P<0.01);Ⅱ组术后房室结有效不应期(313±36 ms)也较术前(280±34 ms)明显延长(P<0.01),心房起搏时最长 A_2H_2间期(180±38 ms)亦较术前(322±39 ms)明显缩短(P<0.01);消融前Ⅰ组最长 A_2H_2间期明显短于Ⅱ组(P<0.05);消融前后两组房室结有效不应期差异不明显(P>0.05)。结论所谓"光滑"房室结功能曲线其实质也是由快径和慢径两部分组成,慢径消融可致曲线"尾巴"消失,这对 AVN—RT 消融的终点判断具有指导意义。
Objective The purpose of this study was to probe into the essence of smooth AV nodal function curve of dual AV nodal pathways(DAVNP).Methods This study consisted of three groups. Group Ⅰ included twelve patients with atrioventricular nodal tachycardia(AVNRT)and smooth AV nodal function curves,group Ⅱ included 12 patients with AVNRT and discontinuous AV nodal function curves, and group Ⅲ was acontrol group.Results In group Ⅰ,the effective refractory period of the AV node (ERPavn)incresed(306±24 ms versus 328±22 ms,P<0.05)and the maxmium A_2H_2 interval(AHmax) measured during atrial extrastimulus testing decreased(280±51 ms versus 205±65 ms,P<0.01)after ablation.In group Ⅱ,ERPavn increased(280±34 ms versus 313±36 ms,P<0.01)and AHmax de- creased(322±39ms versus 180±38 ms,P<0.01)also after ablation.The AHmax of group Ⅱ was more prolonged than that of group Ⅰ(322±39 ms versus 280±51 ms,P<0.05)before ablation and had no sig- nificant change(180±38 ms versus 205±65 ms,P>0.05)after ablation.The ERPavn between two groups had no significant difference both before and after ablation(P>0.05).Conclusion These data sug- gest that the smooth AV nodal function curve is composed of two components which represent fast and slow AV nodal pathways respectively.It is of great importance in determining the end point of radiofre- queney catheter ablation in AVNRT.
出处
《中华心律失常学杂志》
1998年第3期178-180,共3页
Chinese Journal of Cardiac Arrhythmias
