MULTIFOCAL ATRIAL TACHYCARDIA

Of 13 cases of multifocal atrial tachycardia (MAT), 11 had chronic bronchitis and obstructive emphysema with pulmonary infections (7 cor pulmonale and 4 coronary heart disease). This arrhythmia often occurs in cases where the cli- nical condition is severe and may cause further deterioration of cardiopulmonary function. Dif- fuse lesion of the atrial musculature may be the pathologic basis of MAT, while the presence of multiple ectopic foci and probably disturbances in the atrial conduction system is its electrophy- siologic basis. Mortality is very high. It is sug- gested that treatment be directed at abolishing or relieving the underlying diseases, including control of infections and improvement of car- diopulmonary function.     

ATRIOVENTRICULAR JUNCTIONAL TACHYCARDIA WITH WENCKEBACH PHENOMENON

This report presents 2 cases of atrioventri- cular junctional rhythm with Wenckebach phenomenon, one was nonparoxysmal junctional tachycardia with both retrograde and antegrade Wenckebach phenomenon and the other pa- roxysmal junctional tachycardia with antegrade Wenckebach phenomenon and complete bundle branch block.     

CHAOTIC ATRIAL TACHYCARDIA IN 22 INFANTS

Twenty-two cases of chaotic atrial tachycardia (CAT) in infants and children are presented. The features were as follows: the patients were all small infants; most cases were associated with re- spiratory disease; unless the CAT was associated with severe disease, the patients appeared well after the infection was controlled other than in a patient with ventricular septal defect and one with endocar dial fibroelastosis, no evidence of congestive heart failure was noted; CAT reverted spontaneously to sinus rhythm after various lengths of time; other manifestations of atrial ectopic rhythm were also noted; antiarrhythmic treatment was ineffective; and prognosis was good in cases without associated se vere diseases. The electrophysiologic mechanism of this dysrhythmia remains unknown.     

导管射频消融治疗特发性室性心动过速

经导管射频消融治疗１３例特发性室性心动过速（ＩＶＴ）。其中左室ＩＶＴ９例，右室ＩＶＴ４例。９例左室ＩＶＴ中６例消融成功；４例右室ＩＶＴ中位于右室流出道的２例消融成功，另２例失败，其中１例消融后ＶＴ发作频率明显减少且药物易于控制。随访３～２２个月，１例术后１月复发经再次消融成功。结果表明射频消融是治疗ＩＶＴ安全有效的方法。     

RADIOFREQUENCY ABLATION OF IDIOPATHIC RIGHT VENTRICULAR TACHYCARDIA

This paper presents our experieaee with radioreqencey ablation (RFA) for idiopathic ventricular tschycardia (VT) arising from right ventricle in 12 patients(pts). The age range d patients was 21～50, with a mean of 38. 5 years. Ten out of 12 were females, 1 patient had eandia failure due to almost incessant VT while the rest had normal left ventricular function.Twelve pts had VT arising from the fight ventricle; of those, 9 were from the outflow truct, 2 from the RV apex, and l from the RV inflow. In all tats the diagnostic study and therapeutic RFA were combined in a single procedure, pacemapping and local aetlvition time were used to guide the site of RFA in Ors with VT arising froth the tight ventricle.RFA was successful in 11 of the 12 pts ( 91%). Ntmaher of RF applications were 1～27, mean 9. 6; fluoroscopy time were 4～75, mean 26. 9 minutes. RFA for idiopathic RV has a high success rate. This mode of treament should be considered as a nonphartaaeologieal curative treatment for symptomatic pts.     

ATP转复阵发性室上性心动过速20例临床分析

通过对ATP静注转复阵发性室上性心动过速20例临床分析,发现快速静注(5秒钟)转复率高于缓慢静注(>20秒钟);折返型高于自律型。转复失败时,2分钟后,待心率和心律恢复,可以原剂量或增加剂量快速重复静注。     

分支性搏动与室性心动过速的诊断与治疗（附2例报告）

本文报告２例无明显器质性心脏病、心电图示ＱＲＳ时限＜０．１２秒、呈不完全性束支传导阻滞伴电轴偏移的分支性室性心动过速患者。室速经静注异搏定和心律平能中止发作，而对利多卡因静注反应差。并就此类心律失常的诊断与治疗作了简要讨论。     

急性心肌梗塞后非持续性室性心动过速室性心动过速和心室颤动阈值的实验研究

本文采用逐步递增刺激电流强度的程序电刺激方法,测定、分析了急性心肌梗塞后缺血心肌的NSVTT、VTT、VFY的相关性。20只犬为正向序贯R/T法诱发测定了NSVTT、VTT二者(20/20),16只诱发测定了VFT。这16只犬NSVTT、VTT、VFT值各自为7.70±1.42mA,12.85±2.05mA,26.39±4.90mA。NSVTT/VTT,VTT/VFT也为显著相关(r=0.603,P<0.05及r=0.505,P<0.05),NSVTT/VFT呈正相关(r=0.455)。这些结果提示:NSVTT、VTT、VFT值之间有明显相关性。因而,测定NSVTT、VTT,有可能替代测定VFT,反应心脏的电稳定性。     

A-V NODAL DUAL PATHWAYS AND PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA

In 16 cases of paroxysmal supraventricular tachycardia (PSVT), A-V nodal dual pathways were found in nine, and PSVT was initiated with pro- grammed stimulation in seven of the nine cases. In the remaining two cases, atrial echo was seen in one, but in another, PSVT could not be initiated, and atrial echo was not seen. Among the nine cases, there was an unusual one which showed antegrade conduction through fast pathway and retrograde con duction through slow pathway. In seven of the nine cases, there was interruption of HIH2/AIA2 curve and jump phenomenon of HIH2, while in one case the curve was smooth. Jn electrophysiologic studies, A-V dual pathways were not seen in 53 cases without PSVT for various reasons. The authors believe that A-V nodal dual pathways are functional abnormality affected by au- tonomous nervous system. Whether PSVT may be initiated in cases with nodal dual pathways or not depends upon the equilibrium between the rates of coduction in these two pathways and the length of the refractory period.     

艾司洛尔〈爱络〉治疗围手术期窦性心动过速的疗效观察

目的　为了观察艾司洛尔控制围手术期窦性心动过速的疗效。方法　对 30例围手术期窦性心动过速患者单次静注艾司洛尔 1mg/kg ,记录用药前后 1、3、5和 10分钟时心率和相关指标及不良反应。结果　心率分别为 146 .2± 11.49、139.5± 13.78、12 0 .6 9± 12 .99、10 8.0 3± 12 .74及 10 4.37± 14.2 6bpm (F 119.6 1,P <0 .0 1) .病人心率变化有显著差异 (F 4.6 8,P <0 .0 1)。有效率分别为 3.33% (1min)、5 0 % (3min)和 73.33% (5min)。未发现不良反应。结论　艾司洛尔起效快、安全 ,但剂量应个体化。     

特发性左室室性心动过速的射频消融

特发性左室室性心动过速７例，６例于室性心动过速发作过程中行激动顺序标测与消融，消融成功部位的局部心室电图和其前的高频低幅左后分支浦肯野纤维电位较体表心电图ＱＲＳ波提前３０．４±１０．３ｍｓ，而未成功部位提前１２．５±８．０ｍｓ（Ｐ＜０．０１）；１例采用起搏标测方法与消融。７例患者射频消融全部成功，随访１～１３个月无并发症及复发。结果表明，特发性左室室性心动过速发生机理复杂，可为触发活动或折返激动。射频消融疗效肯定，成功的关键是寻找较体表心电图ＱＲＳ波提前２５ｍｓ以上的局部心室电图和高频低幅浦肯野纤维电位。     

42例室性心动过速治疗的临床分析

本文介绍了42例室性心动过速的临床资料和特点,讨论了早期后除极与室性心动过速的关系,并探讨各型室速的治疗。     

射频消融房室旁路及房室结双径路治疗室上性心动过速病例分析

目的：对20例阵发性室上性心动过速患者行射频消融术,观察其疗效及并发症。方法：常规方法行射频消融水。结果：20例手术均获成功,其中1例手术后出现1°房室传导阻滞(1°-AVB),经治疗恢复正常,其余无并发症。结论：射频消融术安全、有效、并发症少。     

经导管射频消融术治疗室上性心动过速15例报道

目的总结经导管射频消融术治疗室上性心动过速１５例的经验和体会。资料和方法１０例系旁路、５例系房室结双径路折返引起的室上性心动过速，接受射频消融术治疗。结果１５例治疗均获成功，随访１１±７个月无复发。结论严格的病例选择、准确的定位及熟练的操作技术是成功的关键。     

非体外循环下双向腔肺分流术的麻醉处理

目的探讨非体外循环下双向腔肺分流术围术期的麻醉处理。方法48例施行非体外循环下双向腔肺分流术患者,年龄5个月~29岁,体重7~51kg,气管插管全麻,采用中小剂量芬太尼(15~20μg/kg)维持麻醉,必要时辅以低浓度的异氟醚吸入,术中通过及时补充血容量,预见性处理循环变化,及时行上腔静脉引流等方法完成手术。结果全组死亡1例,余均顺利完成手术,术后血管活性药物使用时间短,SpO2由术前(75.67±11.08)%升到(89.53±6.56)%,均于术后24h内脱离呼吸机,所有患者呼吸支持时间、输血量、术后胸液量、ICU停留时间均明显少于同期体外循环CPB组(P<0.01)。结论术前正确评估患者病情,术中维护心血管功能稳定和维持低状态肺血管阻力是手术能否顺利进行的关键,同时加强血液保护、脑保护是术后迅速恢复的重要保证。