快径间断逆传是房室结折返性心动过速的少见电生理表现

报道 4例房室结折返性心动过速 (AVNRT)的少见电生理表现———快径间断逆传。 4例经心电图和食管电生理检查证实为AVNRT的病人 ,心内电生理检查中心室刺激无快径逆传 ,遂静脉注射异丙肾上腺素和消融阻断慢径后观察室房 (VA)传导特点。结果 :4例病人基础电生理检查均无快径逆传。静脉注射异丙肾上腺素后心室刺激 ,3例显示快径逆传并诱发AVNRT ,1例仍不显示快径逆传。消融阻断慢径后 ,4例病人均显示良好的快径逆传。结论 :快径间断逆传是AVNRT的少见电生理特点 ,慢径和快径相互干扰是其产生的重要机制之一。

Intermittent Antidromic Conduction of Fast Pathway May be A Rare Electrophysiological Feature of Atrioventricular Nodal Reentrant Tachycardia

This paper reports a rare electrophysiological feature of atrioventricular nodal reentrant tachycardia(AVNRT) in four patients:intermittent antidromic conduction of fast pathway.Four patients had AVNRT recorded in ECG and induced with transesophageal left atrial stimulation.There was no ventriculoatrial(VA) conduction through fast pathway in all patients stimulated at right ventricular apex(RVA) during intracardiac electrophysiological test.The VA conduction function of these patients was evaluated before and after infusion of isoprenaline and ablation of slow pathway.Results:There was no VA conduction through fast pathway before isoprenaline infusion and ablation of slow pathway in all four patients.After isoprenaline infusion three patients had VA conduction through fast pathway and AVNRT,one patient still had no VA conduction through fast pathway.All patients had good VA conduction through fast pathway after slow pathway ablation.Conclusion:It was concluded that some patients with AVNRT may have intermittent VA conduction throughfast pathway,and the mechanism of this rare feature may be the conduction interference between fast and slow pathway.