食管电生理诊断阵发性室上性心动过速

目的探讨食管电生理诊断阵发性室上性心动过速(paroxysmal supraventricular tachycardia,PSVT)及分型的准确性。方法收集经食管电生理和心内电生理检查并行射频消融治疗的PSVT42例,将两种电生理对PSVT的诊断及分型进行比较,用X2检验,以P<0.05为差异有统计学意义。结果两种电生理检查诊断房室结双径路、慢快型房室结折返性心动过速、常见的顺向型房室折返性心动过速差异无显著性,食管电生理对房室旁路的粗略定位准确性较高,但对快慢型房室结折返性心动过速、慢房室旁路参予的房室折返性心动过速与房性心动过速不易辨别。结论食管电生理诊断常见类型的PSVT与心内电生理有相似的价值,且具有无创、简便、费用低等优点;但对不常见或复杂的PSVT不易辨别。

The evaluation of paroxysmal supraventricular tachycardia diagnosed by esophageal electrophysiology

Objectives To investigate the accuracy of diagnosis and classification of paroxysmal supraventricular tachycardia (PSVT) by esophageal electrophysiology study. Methods 42 patients with PSVT underwent both esophageal electrophysiology and intracardiac electrophysiology study on separate day,and diagnosis and classification of PSVT by these two electrophysiology study were compared. Results Diagnosis of dual atrioventricular nodal pathway (DAVNP) and slow-fast atrioventricular nodal reentrant tachycardia (AVNRT) as well as orthodromic atrioventricular reentrant tachycardia (AVRT) were not significantly different between these two electrophysiology study; Location of accessory pathway (AP) was also similar between these two electrophysiology study; but esophageal electrophysiology study couldn't differentiate fast-slow AVNRT, slow AP mediated AVRT and atrial tachycardia compared with intracardiac electrophysiology study. Conclusions Compared with intracardiac electrophysiology study, esophageal electrophysiology study has a similar accuracy of diagnosis and classification of common SVT,and have advantages of noninvasiveness, simplicity and convenience and low cost, but esophageal electrophysiology study couldn' t differentiate uncommon PSVT.