Diagnostic value of transesophageal atrial pacing in patients with paroxysmal supraventricular tachycardia
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摘要: 目的 本研究旨在探讨食道心房调搏对阵发性室上性心动过速(PSVT)的诊断,确定其具体分型,为进一步的射频消融手术提供帮助。 方法 选取经食道心房调搏诱发出PSVT患者61例,测定食道导联的R-P’E、P’E-R时限,Vl导联的R-P’时限,P’波方向,和射频消融术后的结果进行比较。 结果 ①射频消融术后确定的分型如下:慢-快型房室结折返性心动过速[AVNRT (S-F)]25例,快-慢型房室结折返性心动过速[AVNRT (F-S)]1例,顺向型房室折返性心动过速(O-AVRT)左侧旁道24例,右侧旁道7例,双旁道1例;房性心动过速(AT)3例。②食道心房调搏发现R-P’E<70 ms的患者均为AVNRT (S-F),R-P’E>80 ms的患者多为O-AVRT。R-P’E<P’E-R的患者多为AVNRT (S-F)和O-AVRT,R-P’E>P’E-R的患者多为AT。③左侧旁道均为V1导联R-P’>R-P’E,右侧旁道多为V1导联R-P’<R-P’E。④P’在Ⅰ、aVL和V1导联的方向可以对O-AVRT的旁道位置进行大致定位。 结论 食道心房调搏可以对PSVT大致分型,对制订合理的治疗方案,及进一步的射频消融手术都提供了帮助,具有重要的临床价值。
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关键词:
- 食道心房调搏 /
- 阵发性室上性心动过速
Abstract: Objective To investigate the role of transesophageal atrial pacing in diagnosis and specific typing of paroxysmal supraventricular tachycardia(PSVT),thus provide assistance for further radiofrequency ablation. Methods Total 61 cases of PSVT induced by transesophageal atrial pacing were studied by determining R-P'E and P'E-R interval of esophageal lead,R-P' interval of Vl lead,and direction of P',all of which were compared with the results of radiofrequency ablation. Results ①In line with the results of radiofrequency ablation,the types of PSVT among the 61 patients were as follows:25 cases of AVNRT(slow-fast type),1 case of AVNRT(fast-slow type),24 cases of O-AVRT(left-sided accessory pathway),7 cases of O-AVRT(right-sided accessory pathway),1 case of O-AVRT(double pathways),and 3 cases of atrial tachycardia.②Among the 61 cases,those whose R-P'E<70 ms were all AVNRT(slow-fast type),those whose R-P'E>80 ms were mostly O-AVRT,those whose R-P'EP'E-R were mostly atrial tachycardia.③Those cases whose V1 lead R-P'>R-P'E were all left-sided accessory pathway,and those whose V1 lead R-P'
Conclusion Transesophageal atrial pacing has high clinical value in typing of PSVT,developing treatment programs and providing assistance for further radiofrequency ablation.
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