经食管心房调搏对阵发性室上性心动过速的诊断价值

目的 探讨经食管心房调搏对阵发性室上性心动过速的分型及定位诊断价值。方法 回顾性分析食管心房调搏对193例阵发性室上性心动过速分型及定位诊断结果，并与心内电生理检查诊断结果比较。结果 经食管心房调搏对慢-快型AVNRT及顺向性AVRT的诊断敏感性、特异性、准确性均较高，对少见型AVNRT的诊断敏感性低(25％)。结论 阵发性室上性心动过速发作时食管与体表心电图P^-波起始与极性是诊断阵发性室上性心动过速的关键。经食管心房调搏对心动过速旁道定位误诊原因主要是心动过速时体表心电图P^-波往往与T波融合，导致V1、I导联P^-波极性及V1导联P^-波起始部形态改变。

Diagnosis value of transesophageal atrial pacing for paroxysmal superventricular tachycardias

Objective To evaluate diagnosis value of transesophageal atrial pacing(TEAP) for type and location of paroxysmal superventricular tachycardias(PSVT). Methods Typing and locating consequences evaluated by TEAP were reviewed and compared to that confirmed by intracardial electrophysiology study (EPS) in 193 patients with PSVT. Results Sensitivity, specificity and accuracy of TEAP were higher in diagnosis of slow-fast type of atrioventricular nodal reentrant tachycardia (AVNRT) and orthodromic type of atrioventricular reentrant tachy cardia(AVRT). While sensitivity of TEAP in diagnosing seldom type of AVNRT was low(25%) and main reason for it was that P- overlap T in surface electrocardiogram leading to identify initiation and polarity of P- wave difficultly in leads V1 and I. Conclusion Initiate and polarity of P- wave both in Esophagus electrocardiogram and Electrocardiogram are critical of diagnosis for PSVT.