摘要
目的 探讨简便、快捷鉴别疑难的房室及房室结折返性心动过速与房性心动过速的方法。方法 分别对 2 0例间隔旁路 (包括 4例慢旁路 ) ,2 0例房室结双径路 (包括不典型房室结双经路 1例 )以及 11例房速 (6例房速 ,5例房室结双径路慢径路消融术后 S1 S1 心房刺激模拟房速 )患者 ,在心动过速过程中行心室 RS2 刺激 ,所有患者心室 RS2 刺激均能夺获心室并且逆传心房 ,而且不终止心动过速 ,观察心室刺激时心房的反应 ,反应方式分别为 V′- A′- V- A (V′:S2 刺激后心室波 ,A′:V′波逆传心房波 ,V :心动过速时室波 ,A:心动过速时房波 )或 V′- A′- A - V。结果 2 0例间隔区房室折返性心动过速的患者 ,心室 RS2 刺激的反应方式均为 V′- A′- V- A,其中 16例 V′A′间期 <A′- V间期 ,4例慢旁道 V′A′间期 >A′V间期 ,V- A均较远 (>6 0 ms) ,V′A′间期与 VA间期相近。2 0例房室结折返性心动过速病人行心室 RS2 刺激的反应方式呈 V′- A′- V - A14例 ,呈 V′- A′- A- V 6例 ,1例不典型房室结折返性心动过速患者 VA间期130 ms,余 13例呈 V′- A′- V - A反应的患者 VA均较近 (VA<6 0 m s) ,6例呈 V′- A′- A - V的患者 AV较近或者融合 (AV<6 0 m s)。 6例房速以及 5例模拟房速患者心室 RS2 刺激均呈 V?
Objective To find a rapid and easy way to differentiate atrial tachycardial from difficulted atrioventricular and atrioventricular nodal reetrant tachycaridia.Method Programmed ventricular RS 2 stimulation was performed during tachycardia from 20 patients with septal accessory pathway(4 patients with slow atrioventricular accessory pathway),20 patients with atrioventricular nodal reetrant tachycardia(one patient with atypical atrioventricular nodal reentrant tachycardia) and 11 patients with atrial tachycardia(6 patients with atrial tachycardia,5 patients simulatied atrial tachycardia by atrial S 1S 1 150bpm stimulation).The programmed ventricular RS 2 stimulation could capture ventricle,and conduct retrogradely to atrium under the condition that it didn't terminate the tachycardia.The electrogram sequence upon cessation of ventricular RS 2 stimulation was categorized as 'ventricular-atrial-ventricular-atrial(V′-A′-V-A)' or 'ventricular-atrial-atrial-ventricular(V′-A′-A-V)'.Results Under the programmed ventricular RS 2 stimulation,the reaction of the 20 patients with septal accessory pathway was V′-A′-V-A;In the 20 patients with atrioventricular nodal reentrant tachycardial,14 of them took on as V′-A′-V-A,the other 6 ones as V′-A′-A-V;The reaction of 11 patients with atrial tachycardial were V′-A′-A-V.Conclusion the programmed ventricular RS 2 stimulation during tachycardia is a rapid and easy way to differentiate atrial tachycardial from difficulted atrioventricular and atrioventricular nodal reentrant tachycardial.
出处
《临床心电学杂志》
2001年第2期81-83,共3页
Journal of Clinical Electrocardiology
关键词
房性心动过速
房室折返性心动过速
房室结折返性心动过速
Atrial Tachycardia Atrioventricular Reentrant Tachcaridia Atrioventricular Nodal Reetrant Tachycaridia
