三磷酸腺苷静注诊断10例隐性预激综合征

选择窦性心律时心电图无心室预激波(PEC)的44例阵发性室上速和6例仅有短PR间期者施行三磷酸腺苷(ATP)分级递增快速静注(ATP_Ⅳ)和诊断性电生理研究(DEPS)。结果:ATP_Ⅳ和DEPS分别揭示出隐性预激综合征(PE_L)10/50例和9/50例;ATP_Ⅳ揭示的10例PE_L中有6例在显示PEC前或中出现非预激搏动的房室结传导延缓或阻滞;ATP_Ⅳ未生严重并发症。提示(1)ATP_Ⅳ是诊断PE_L的一种简便、敏感和较安全的方法;(2)ATP_Ⅳ时PEC的揭示主要与ATP对房室结前向传导的负性变导性作用有关。

Intravenous Adenosine Triphosphate forIdentifying Ten Cases of Latent Preexcitation

To assess the effects of adenosine triphosphate (ATP) in unmasking latentpreexcitation (PE_L), test of step-wise increamental doses of intravenous bolus ATP(ATP_(IV)) and diagnostic electrophysiologic study (DEPS) were carried out in 44 patients withparoxysmal supraventricular tachycardia and normal electrocardiagram during sinus rhythmand 6 with only short PR interval. The results showed that of the 50 patients examined bothATP_(IV) and DEPS unmasked preexcited QRS complex (PEC) in 10 and 9 cases respectively.In 6 of the 10 patients with PE_L unmasked by ATP_(IV), atrioventricular nodal conduction delayor block of nonpreexcited beats was induced before or during the appearance of PEC. No se-vere complications were observed during the study. These results suggest that (1)ATP_(IV) issimple, sensitive and relatively safe for identifying PE_L and (2) the unmasking of PEC byATP_(IV) is mainly due to negative dromotropic action of ATP on anterograde conduction of a-trioventricular node.