房室结折返性心动过速经不同方式起搏的诱发率及电生理特性

探讨右房、右室刺激诱发房室结折返性心动过速(AVNRT)的规律及电生理特性。58例经食管调搏诊断为AVNRT的患者,在行射频导管消融(RFCA)前接受心内电生理检查(经右房、右室的程序期前刺激和分级递增刺激)。结果:38例经右房和右室刺激均可诱发,有13例仅能经心房刺激诱发,4例仅能经心室刺激诱发,其中3例仅能为心室分级递增刺激诱发;3例静脉点滴异丙肾上腺素或静脉注射阿托品后再次心房或心室刺激诱发;单纯经心室分级递增刺激诱发的AVNRT,其心房程序刺激的AH最大值(AHmax)短于心室分级递增刺激诱发AVNRT时的AH值及心动过速时的AH值(AHSVT)。而同时经心室及心房刺激诱发的心动过速,其AHmax长于仅能经心房刺激诱发AVNRT时AH值及AHSVT,P均<0.05。结论:多数AVNRT患者均可经右房和右室刺激诱发,能够引起足够长AH值的刺激部位及方法均可诱发AVNRT。

The Induced Rate and Electrophysiological Characteristic of Atrioventricular Nodal Reentrant Tachycardias by Different Pacing Models

To discuss the rule and electrophysiological characteristic of stimulating modes on atrioventricular nodal reentrant tachycardias(AVNRT) in right atria and right ventricle,58 cases who had accepted esophageal pacing examination and were diagnosed as AVNRT were perfomed premature stimulating and gradually increasing stimulating during radiofrequency catheter ablation. Results:Tachycadria could be induced not only in right atria but also in right ventricle in 38 cases,only in atria in 13 cases,only in ventricle in 4 cases and only in right ventricle in 3 cases by gradually increasing stimulating.Tachycardia was induced in 3 cases by atria and ventricle stimulating after intravenous dropping isoprenaline and injecting atropine.AH maximum(AH_(max)) by atrial programme stimulating was shorter than by ventricular gradually stimulating and during tachycardia(AH_(SVT)) in patients who was induced AVNRT only by ventricular gradually stimulating.AH_(max) in patients who was induced ANNRT by both ventricular and atrial stimulating was longer than AH,AH_(SVT) in those who was induced AVNRT only by atrial stimulating( P<0.05).Conclusion:Majority AVNRT could be induced by right atrial and ventricular stimulating.The stimulating positions and models which could enhance enough AH can induce AVNRT .