小儿室上性心动过速的食管心电生理分型及演变

目的 :探讨小儿室上性心动过速 (SVT)的类型及其电生理特征 ,以及食管起搏对小儿SVT的干预作用。方法 :对 4 7例 8个月～ 15岁有SVT发作史的患儿进行了食管心电生理研究。结果 :4 7例SVT经食管心房调搏 (TEAP)确定分型 4 2例 (89.4 % ) ,其中旁路折返 2 8例 (6 6 .7% ) ,房室结内折返 10例 (2 3.8% ) ,心房内折返l例 ,窦房结折返l例 ,心房自律性增高 2例 ;不能定型 5例 (10 .6 % )。结论 :小儿SVT近 95 %为折返机制所致 ,以旁路折返最常见 ,其次为房室结内折返 ,与成人报道不同 ,可能与小儿传导系统发育规律以及旁路电生理特性发生演变有关

Transesophageal electrophysiological differentiation and management of paroxysmal supraventricular tachycardia in children

Objective:To assess the underlying mechanism and electrophysiological characteristics of paroxysmal supraventricular tachycardia (SVT) in children. Methods:Forty seven patients aged from eight months to fifteen years with documented history of SVT underwent transesophageal atrial pacing (TEAP) for the diagnosis and management of SVT. Results:The electrophysiological mechanism was confirmed by TEAP in forty two ( 89.4 %) of forty seven patients, including accessory pathway reentry in twenty eight cases ( 66.7 %), atrioventricular node reentry in ten ( 23.8 %), intra atrial reentry in one, sinus node reentry in one and atrial ectopic tachycardia in two. In addilron there were undefined in five cases ( 10.6 %). Conclusion:Almost ninety five percent of SVT are caused by reentry in children. Accessory pathway reentry is the most common type of SVT, and atrioventricular node reentry is second in this group, which are different from those in adult. This discrepancy might be related to changes of conduction system and electrophysiologic evolution of accessory pathway during growing up.