射频消融治疗老年人室上性心动过速109例

射频消融治疗老年人室上性心动过速１０９例马长生，孙英贤，胡大一，商丽华，杨新春，董建增，刘旭一、对象与方法对象为本院１９９１年１０月至１９９５年２月１３００例射频电消融术中的老年患者１０９例，男６８例，女４１例；年龄６０～８０岁，平均６６．３±７．１...     

老年人室上性心动过速射频消融治疗21例

老年人室上性心动过速射频消融治疗２１例吴书林，李海杰，欧阳非凡，郑祥生，尹滔业，孙家珍，冯建章一、临床资料１９９１年１０月至１９９４年１１月我院共有２１例老年室上性心动过速（ＳＶＴ）患者行射频消融术（ＲＦＣＡ）。男１２例、女９例，年龄６０～７０岁、平...     

射频消融治疗阵发性室上性心动过速观察

<正> 近年来射频导管消融(RFCA)根治阵发性室上性心动过速(PSVT)的技术已趋成熟并且较迅速地推广,我科自1997年以来共消融PSVT48例.现将初步结果介绍如下.1 资料与方法1.1 一般资料:48例行RFCA术患者,男性20例,女性28例,平均年龄41±14(18—72)岁,心动过速频率150—250bpm,持续时间最短3分钟,最长3天.其中     

室性心动过速合并室上性心动过速的射频消融

目的报道7例室性心动过速（VT）合并室上性心动过速（sVT）的射频消融。方法7例患者男6例,女1例,平均年龄（21±9）岁。阵发性心动过速病史（3．7±2．0）年。术中心房和心室刺激诱发VT和SVT,并进行消融。结果7例患者心房或心室刺激能反复诱发和终止VT合并SVT。法洛四联症矫治术后右心室VT合并三尖瓣环峡部依赖性心房扑动（AFL）1例,其余6例均为维拉帕米敏感性左心室特发性室速（ILVT）,分别合并AFL1例,左后间隔旁路参与的顺向型房室折返性心动过速（AVRT）1例,冠状静脉窦口慢旁路参与的顺向型AVRT1例,慢慢型房室结折返性心动过速（AVNRT）1例,左侧游离壁旁路参与的顺向型AVRT2例。7例患者的两种心动过速均成功消融,所有患者消融术后随访2年,无一例VT或SVT复发。结论VT合并SVT并不少见,消融术中应放置必需的心腔内电极导管,完成详细电生理检查,避免漏诊。一次消融应根除两种疾病。     

房室结双径路与间隔旁路所致折返性心动过速的鉴别诊断

室上性心动过速(SVT)是临床常见的心律失常，通过心脏电生理检查精确定位是射频导管消融治疗成功的关键。     

射频消融治疗阵发性室上性心动过速37例报告

射频消融术 (RFCA)已成为治疗各种原因的阵发性室上性心动过速的重要的非药物性治疗方法之一 [1— 3] 。我院于 1 999年 1月至 2 0 0 2年 4月用 RFCA方法治疗 3 7例阵发性室上性心动过速病人 ,现将治疗结果及点滴体会报告如下 :1　资料和方法1 .1　一般资料 :3 7例中男 2 0例 ,女 1 7例 ,年龄 2 1～ 79岁 (平均 44± 5 )岁。阵发性室上性心动过速病史 2～ 4年 ,虽经多种药物治疗仍发作频繁 ,无器质性心脏病。消融治疗前电生理检查证实房室结双径路 (A2— H2跳跃≥60 ms) 1 5例 ,房室旁路 2 4例 (左侧旁道 1 6例 ,右侧旁道8例 )。其中 2…     

射频消融治疗室上性心动过速的临床疗效评价

采用射频电流导管消融（ＲＦＣＡ）治疗室上性心动过速（ＳＶＴ）５１９例，总成功率为９５．０％（４９３／５１９）。其中旁道参与的ＳＶＴ３７９例（共３８４条旁道），离断３７５条，成功率（９７．７％）；房室结折返性心动过速１３４例，阻断慢径成功率９４．７％（１２６／１３３）；房性心动过速６例，成功４例，成功率６６．７％。８例患者出现并发症。随访１￣５２月，２４例ＳＶＴ复发（４．６％），再次接受ＲＦＣＡ后均     

射频消融治疗老年室上性心动过速

老年室上性心动过速（ＳＶＴ）患者往往合并症多，发作时症状较重，而药物治疗毒副作用较大。射频消融术（ＲＦＣＡ）治疗老年ＳＶＴ是近几年来采用的比较理想的治疗方法，但由于老年人动脉硬化、冠心病、心肌退行性变等基础疾病的存在，给ＲＦＣＡ治疗老年ＳＶＴ带来一定...     

射频消融治疗室上性心动过速333例临床分析

目的 总结射频电流导管消融(RFCA)治疗室上性心动过速(SVT)临床资料。方法 采用RFCA治疗SVT333例。结果总成功率为97.3%,其中旁道参与的SVT 216例,离断207条,成功率95.8%;房室结折返心动过速(AVNRT)117例,阻断慢径117例,成功率100%;2例出现并发症。随访半年,9例SVT复发(2.7%),再次接受RFCA后获成功。结论 射频消融为治疗SVT的一种安全有效的方法。     

Schwannoma of the nasal septum: a case report

Schwannoma is a neurogenic tumor arising from the sheath of myelinated nerves. Only 4% of schwannomas located in the head and neck region involve the sinonasal tract, and those arising from the nasal septum are exceedingly rare. We report a case of a 55-year-old male who presented with only right nasal obstruction. Computerized tomography and clinical examination suggested a benign tumor before the tumor was completely removed by transnasal endoscopic surgery. When encountering a mass in the nasal cavity, schwannoma should be borne in mind in the differential diagnosis. We discuss the clinical presentation, histologic features, differential diagnosis, and therapeutic options for such a rare lesion.     

Differential diagnosis of supraventricular tachycardia

We firmly believe that a systematic approach to the 12-lead ECG can provide information that can diagnose the difference between ventricular and supraventricular tachycardia, and in many instances diagnose the mechanism and site of origin of the supraventricular tachycardia. The mechanism of supraventricular tachycardia is able to be diagnosed in more than 80% of narrow complex tachycardias, and one should be able to distinguish supraventricular from ventricular tachycardia in more than 90% of tachycardias. In the presence of aberration, the mechanism of supraventricular tachycardias is more difficult to define unless retrograde P waves are seen. In such instances the morphology of the P wave (if seen), the effect of oscillation of cycle length on the RP interval, and response to vagal maneuvers may be useful in distinguishing mechanisms for ventricular tachycardia.     

Nasal septum adenoid cystic carcinoma: a case report

Adenoid cystic carcinoma of the nasal septum is extremely rare. We present the case of a 56-year-old male who complained of nasal bleeding and nasal obstruction for 1 month. A mass arising from nasal septum was found by endoscope. The tumor was removed under lateral rhinotomy and histopathologic examination revealed adenoid cystic carcinoma with cribriform pattern. He then had postoperative radiotherapy. No recurrence was noticed after 1 year of follow-up. Despite its rarity, adenoid cystic carcinoma should be taken into consideration in the differential diagnosis of nasal tumor.     

小儿室间隔纤维瘤1例

1病例资料患儿,男,4岁。两年前发现心脏杂音,超声心动图示室间隔左心室流出道处局部增厚,室间隔肿物性质待查。两年来无明显临床表现,活动如同龄儿,发育正常。体检:胸骨左缘3～4肋间扪及收缩期震颤,闻及2～3/6收缩期杂音。X线胸片:心影饱满,C/T 0.56(图1)。心电图:窦性心律,心率102次/min。超声心动图:室间隔近心底部圆形中等回声团块,30 mm×19 mm×25 mm,边     

Drug-induced supraventricular tachycardia: a case report of fluoxetine

We report the occurrence of supraventricular tachycardia and hypotension in a 54-year-old woman after maintenance therapy with fluoxetine. Although cases of tachycardia and palpitations have been reported, supraventricular tachycardia and hypotension have not been directly attributed to fluoxetine.     

Bi-directional ventricular tachycardia and pheochromocytoma: a case report

We present the case of a 48 year old woman who was admitted to our university hospital in cardiogenic shock with bi-directional ventricular tachycardia degenerating into polymorphic venricular tachycardia which resolved spontaneously. Investigation revealed healthy coronary arteries but severe left ventricular dysfunction due to akinesia involving the entire base. There was a rapid improvement within several days. The diagnosis of bilateral phaeochromocytoma was made on the biochemistry and CT scan of the adrenals.     

Intraventricular concealed double tachycardia: a case report.

An electrophysiologic study was performed on a patient with ischemic sustained ventricular tachycardia (VT). During pacing at the right ventricular apex, ventricular double potential was recorded at the left ventricular apex. Sustained VT was induced by double extra stimuli from the right ventricular apex. Three types of VTs with different QRS morphologies were observed, and each VT was changeable to other types. The interval between one of the two potentials and the surface QRS was constant during all VTs, but the other potential showed dissociation from the surface QRS. During this dissociation, an intrinsic rhythm of the potential was sometimes shorter than the cycle length of the VT. The mechanism of a block between the VT and a bystander could hardly explain these electrophysiologic findings. Concealed double ventricular tachycardia was considered to be the likely mechanism.