持续交界性心动过速的电生理特点和射频消蚀治疗  

The electrophysiological characteristics of sustained junctional reciprocating tachycardia and its radiofrequency catheter ablation

作　　者：江洪[1] 黄从新[1] 李庚山[1] 陈元秀[1] 唐其柱[1] 王晋明[1] 漆曙辉[1] 陈芳[1] 王小红[1] 左进[1] 

机构地区：[1]湖北医科大学附属第一医院心脏内科

出　　处：《中华心血管病杂志》1995年第4期249-251,共3页Chinese Journal of Cardiology

基　　金：湖北省科学技术委员会资助

摘　　要：报道５例持续交界性心动过速（ＳＪＲＴ）的电生理特点和射频消蚀（ＲＦＣＡ）治疗。结果表明，５例患者的室房传导和心动过速的逆传支为具有递减传导性能的隐匿性房室旁路（ＡＰ）。电生理特点为：（１）心室刺激与心动过速的逆传心房顺序相同；（２）右室间隔上部刺激的室房传导时间明显短于右室尖部刺激；（３）心动过速时于Ｈ波同步刺激心室可逆传至心房且使之提前激动；（４）４例ＲＦＣＡ成功阻断ＡＰ，３例ＡＰ位于右后隔区，１例位于中隔区；（５）４例ＡＰ阻断后，３例显示室房分离，１例显示正常室房传导。结论认为，ＳＪＲＴ的发生机理为房室折返性心动过速，ＲＦＣＡ是安全有效的治疗方法。Abstract Five patients with sustained junctional reciprocating tachycardia (SJRT) underwent electrophysiological test and radiofrequency catheter ablation (RFCA).Detailed results from electrophysiological tests supported that all of the patients had a concealed accessory pathway which had decremental conduction properties during ventricular pacing and tachycardia. The electrophysiological characteristics were:(1) the same atrial activation sequence during right ventricular pacing and tachycardia,(2) the ventriculoatrial intervals much shorter during septal summit pacing than apical pacing,(3) atrial preexcitation when pacing ventricle simultaneous with H wave during tachycardia,(4)three of the 4 accessory pathways abolished by RFCA located in right posteroseptal region and another one in midoseptal region,and (5)ventriculoatrial block in three patients and normal ventriculoatrial conduction in one patient after RFCA.It was concluded that SJRF was a special atrioventricular reentrant tachycardia caused by concealed decremental accessory pathway and this tachycardia could be treated safely with RFCA.

关 键 词：室上性 心动过速 电生理学 消蚀术 射频消蚀 

分 类 号：R541.710.5[医药卫生—心血管疾病]