依赖异丙肾上腺素逆传的房室折返性心动过速

目的：探讨4例依赖异丙肾上腺素逆传的房室折返性心动过速的发作情况及电生理特点。方法：对4例射频导管消融前常规电生理检查未能诱发出阵发性定性心动过速及A－H间期跳跃，亦未见旁道逆传者，静脉滴注异丙肾上腺素、右心室刺激时发现左侧旁道逆传，并均诱发出正向型房室折返性心运过速；停止注射后，左侧旁道逆传功能消失，亦不能诱发出房室折返性心动过速。结果：静脉滴注异丙肾上腺素，右心室起搏下用逆行法于二尖瓣环心室侧消融，4例均获成功；术后静脉滴注异丙肾上腺素下再行右心室起搏，未见旁道逆传现象。结论：部分隐匿性旁道构成的房室折返性心动过速发作依赖异丙肾上腺素，射频导管消融在静脉滴注异丙肾上腺素及右心室起搏下进行。

AV reentrant tachycardia due to concealed accessory pathway with retrograde conduction manifested by isoproperenol

Objective To evaluate electropysiologic features and radiofrequenry catheter ablation (RFCA) in four patients with AV reentrant tachycardia (AVRT) due to concealed accessory pathway with retrograde conduction manifested by isoproperenol. Methods Four patients with AVRT were performed RFCA,AVRT could't be bring out in all patients during electrophysiologic test. And there was no A-H jump.Accessory pathway retrograde conduction can't be finded during stimulating right ventricular while there were left concealed accessory pathways retrograde conduction can be found after injection isoproperenol intravenously in four patients. Results RFCA were performed on four patients with injection isoprperenol intravenously; and all cases were ablated successfully. Conclusion Some AVRT with left concealed pathway retrograde conduction may be manifested by isoproperenol; RFCA should be performed with injection isoproperend intravenously.