摘要
为探讨快速心房起搏最短１∶１房室传导时最大ＰＲ间期（ＰＲｍａｘ）与ＲＲ间期比值（ＰＲｍａｘ／ＲＲ）在鉴别阵发性室上性心动过速中的意义，分析比较了２０例房室结折返性心动过速（ＡＶＮＲＴ，有房室结前传跳跃现象者１２例、无跳跃现象者８例）和２０例房室折返性心动过速（ＡＶＲＴ）患者消融前、后快速心房起搏时最短１∶１房室传导的ＰＲｍａｘ／ＲＲ。ＡＶＮＲＴ组消融前、后心房快速起搏时最短１∶１房室传导的ＰＲｍａｘ／ＲＲ为１．１２±０．１２和０．４２±０．０７，两者比较差异有高度显著性，Ｐ＜０．０１；ＡＶＲＴ组为０．５２±０．１６和０．５１±０．１８，两者比较差异无显著性，Ｐ＞０．０５。消融前，ＡＶＮＲＴ组ＰＲｍａｘ／ＲＲ与ＡＶＲＴ组相比有显著性差异（１．１２±０．１２ｖｓ０．５２±０．１６，Ｐ＜０．０１）。ＰＲｍａｘ／ＲＲ＞１诊断ＡＶＮＲＴ的敏感性为９０％、特异性９１％。提示ＰＲｍａｘ／ＲＲ＞１在消融前可用来鉴别ＡＶＮＲＴ与ＡＶＲＴ；对无房室结前传跳跃的ＡＶＮＲＴ。
This study tested the value of PRmax/RR ratio in identifying atrioventricular nodal reentrant tachycardia (AVNRT) from atrioventricular reentrant tachycardia (AVRT).The PRmax/RR ratio during rapid atrial pacing of 20 paitnets with AVNRT (12 cases had fast to slow pathway jumping,8 cases had no jumping) was compared with that of 20 patients with AVRT.The PRmax/RR ratio with 1 to 1 atrioventricular conduction during atrial pacing with the shortest cycle length were measured before and after radiofrequency ablation.Results:the PRmax/RR ratio became shorter after slow pathway ablation (from 1.12±0.12 before ablation to 0.42±0.07 post ablation,P<0.01) in patients with AVNRT.There was no changes in PRmax/RR ratio(0.52±0.16 vs 0.51±0.18,P>0.05) before and after ablation of accessory pathway in patients with AVRT.Before ablation,there was significant difference in PRmax/RR ratio in patients with AVNRT compared to patients with AVRT (P<0.01).Of PRmax/RR>1 had a sensitivity of 90%,specificity of 91% in identifying patients with inducible AVNRT.Conclusion:The PRmax/RR ratio is a valuable index in identifying AVNRT from AVRT.In patients without jumping,the PRmax/RR ratio <1 after ablation could used as an index for successful ablation of slow pathway.
出处
《中国心脏起搏与心电生理杂志》
1997年第4期188-190,共3页
Chinese Journal of Cardiac Pacing and Electrophysiology
