房室结折返性心动过速合并束支阻滞时心内电图特征

探讨房室结折返性心动过速 (AVNR)合并束支阻滞时心内电图特征及其机制。 6 0例AVNRT患者 ,男 2 3例、女 37例 ,年龄 39± 11岁。将病例分为 3组 :Ⅰ组合并左束支组滞 (CLBBB) ;Ⅱ组合并右束支阻滞 (CRBBB) ;Ⅲ组无束支阻滞。心内电生理测定心动过速的频率 (HR)、冠状窦口A波至V波的距离 (AVcs)、His束处A波到V波的距离 (AVH)。三组心动过速的心率分别为 171± 2 3,16 6± 19,170± 17次 /分 ,三组之间差异无显著性 (P >0 .0 5 ) ;Ⅰ组与Ⅱ、Ⅲ组AVcs、AVH 比较 ,差异有显著性 ( 81± 12msvs 46± 11ms,49± 9ms;5 6± 13msvs 5 1± 10ms、5 0± 10ms,P均 <0 .0 5 ) ;Ⅱ组与Ⅲ组之间AVcs、AVH 差异无显著性。结论 :AVNRT合并束支阻滞时心动过速的心率无明显变化 ;当合并CLBBB时 ,His束到心室的传导时间延长 ,导致冠状窦与His束处的A、V间距延长 ;合并CRBBB时无上述现象发生。

The Characteristics of Intracardiac Electrocardiography in Atrioventricular Nodal Reentrant Tachycardia Complicated by Bundle Branch Block.

The purpose of this study is to observe the characteristics of intracardiac electrocardiography in atrioventricular nodal reentrant tachycardia(AVNRT) complicated by bundle branch block.Sixty patients including 23 male and 37 female,were 39±11 years old.These patients were divided into three groups,Ⅰ group with completely left bundle brach block(CLBBB);Ⅱ group with completely right bundle branch block(CRBBB);Ⅲgroup without bundle branch block.The heart rate(HR) of tachycardia,interval of A wave to V wave of ostium coronary vein (AVcs)and His bundle(AV H )were measured.Results:HR of tachycardia were 171±23,166±19,170±17 beat/min respectively,there was no difference among three groups;there were significantly difference of AVcs and AV H between Ⅰ and Ⅱ or Ⅲ groups(81±12 vs 46±11 or 49±9 ms,P<0.05;56±13 vs 51±10 or 50±10 ms,P<0.05);there was no difference of Avcs and AV H between Ⅱ and Ⅲ groups.Conclusion:There was no changes of HR in tachycardia of AVNRT complicated by bundle branch block;interval of A wave to V wave of AVcs and AV H are longer when AVNRT complicated by CLBBB.