异丙肾上腺素判定房室结内折返性心动过速消融终点的临床意义

目的 探讨异丙肾上腺素判定房室结内折返性心动过速消融终点的临床意义。方法 对97例房室结内折返性心动过速患者，消融前后作使用及不使用异丙肾上腺素自身对照进行心内电生理检查。结果 70例(95％可信区间63％—81％)可诱发室上性心动过速，消融后观察30min，心内电生理检查不能诱发。27例(95％可信区间19％—38％)消融前不能诱发室上性心动过速，静脉滴注异丙肾上腺素后再重复心内电生理检查，均能够诱发室上性心动过速；消融后观察30min，均无室上性心动过速。结论 判定常规心内电生理检查不能诱发心动过速的房室结内折返性心动过速患者的消融终点。宜在使用异丙肾上腺素后再重复同样程序的刺激，并以不能诱发为指标。

Clinical significance of administration of Isoproterenol for evaluation of ablation endpoint of A-V nodal reentry tachycardias

Objective To assess clinical significance of administration of Isoproterenol for evaluation of ablation endpoint of A-V nodal reentry tachycardias. Methods A total of 97 patients were studied. Endo-cardial electrical stimulations were performed without and with Isoproterenol before and after RF catheter ablation. Results An AVNRT was inducible in 70 patients without use of Isoproterenol but was not inducible after successful ablation observation was given for 30 minutes in these 70 patients.In 27 patients in whom there was no tachycardia inducible before ablation,Isoproterenol was given,and stimulation protocol was repeated. Ablated and observed for 30 minutes, tachycardia was not inducible in 27 patients. Conclusion To determine endpoint of ablation in patients who had no inducible tachycardias by routine endocardial electrical stimulation protocol, it had be better to use following as index: to perform same stimulation protocol after use of Isoproterenol and tachycardias could not be induced in patients.