ATP静注和心房调搏对隐性WPW诊断价值的比较  

Comparison of valure of intravenous adenosine triphosphate and atrial pacing for identifying latent preexcitation

作　　者：何国平 黄元铸[2] 马文珠[2] 

机构地区：[1]镇江市第一人民医院心脏科,212002 [2]南京医学院第一附属医院心脏科

出　　处：《临床心血管病杂志》1994年第1期9-11,共3页Journal of Clinical Cardiology

摘　　要：选择50例窦性心律时心电图正常的阵发性室上性心动过速患者施行了心房调搏和三磷酸腺苷(ATP)分级递增快速静注试验(ATP_(iv)),以评价ATP对隐性预激综合征(WPW)的诊断价值.结果为:心房调搏和ATP_(iv)分别揭示出心室预激波10和11例,后者中7例在显示心室预激波前或中出现了非预激搏动的房室结传导延搁或阻滞;ATP_(iv)未发生严重并发症.提示:①ATP_(iv)是诊断隐性WPW的一种敏感的较安全的方法,比心房调搏简便易行;②ATP_(iv)时心室预激波的揭示主要与ATP对房室结前传的负性变导性作用有关.To assess the effects of adenosine triphosphate(ATP) in unmasking latent preexcitation, testing with step-wisp increan.ental doses of intravenous bolus ATP (ATPiv) and atrial pacing were carried out in 50 patients with paioxysmal supraventricular tachycardia and normal electrocardiogram during sinus rhythm. ATPiv and atrial pacing unmasked preexcited QRS complex in 11 and 10,respectively, of the 50 patients examined. In 7 of the 11 patients with latent preexcitation unmasked by ATPiv, atrio ventricular nodal conduction delay or block of non-preexcited beat was induced before or during the appearance of preexcited QRS complex;and no severe complications were observed during the study. These results suggest that(l)ATPiv is a sensitive,relatively safe and,as compared with atrial pacing,more simple method for identifying latent preexcitation, and (2) the unmasking of preexcited QRS complex by ATPiv is mainly due to negative dromotropic action of ATP on anterograde conduction of atrioventricular node.

关 键 词：腺苷三磷酸 预激综合征 心房调搏 

分 类 号：R541.770.4[医药卫生—心血管疾病]