房室结双径路室房传导特征的探讨  

The Retrograde Atrioventricular Conduction Properties in Patients with DualAtrioventricular Nodal Pathways before and after Ablation

作　　者：叶行舟[1] 马长生[1] 杨新春[1] 商丽华[1] 董建增[1] 胡大一[1] 

机构地区：[1]南京铁道医学院附院,北京红十字朝阳医院

出　　处：《铁道医学》1996年第3期131-133,共3页Railway Medical Journal

摘　　要：对１５０例房室结双径路并房室结折返性心动过速（ＡＶＮＲＴ）者心内电生理检查，发现（１）１００％病例存在室房传导；（２）５０．９％右室Ｓ１Ｓ１利激可出现文氏阻滞，４９．１％病例则直接表现为１：１传导突变到２：１传导；（３）４１％病例在室房文氏阻滞或２：１传导发生前Ｖ—Ａ值始终恒定不变，余５９％病例Ｖ—Ａ值延长２２±１３ｍｓ，表现弱的速减传导；（４）在１２７例次Ｖ２后可见Ｈ２波的病例中，Ｖ２一Ｈ２随Ｓ１Ｓ１缩短而延长，Ｈ２一Ａ２在１２１例次中保持不变，６例延长１０～２０ｍｓ．认为房室结双径路并ＡＶＮＲＴ患者室房传导及房室结快径逆传具有其特有的非递减传导或弱递减传导特性。The retrograde atrioventricular (AV )conduction properties before and after radio frequency catheter ablation (RFCA) were studied in 150 patients (pts) with dual atrioventricular nodal pathway (DANP) mediatedatrioventricular nodal reentrant tachycardia(AVNRT). The results revealed as follows:1, all pts exhibited retrograde AV conduction. 2, incermental stimulation from right ventricular apex, Wenckebach retrograde AV conduction demonstrated in 76 pts (50. 9%),whereas, 2: 1 retrograde AV conduction displayed in 74 pts (49. 1%) without typical Wenckebach phenomenon. 3, incrementalstimulation at a cycle length longer than that at which Wenckebach or 2: 1 retrograde AVconduction occurred, decremental retrograde AV conduction demonstrated in 88 pts. (59% )with a difference of 22± 13 ms between the maximal and the minimal VA intervals,whereas, a fixed VA interval kept in 62 pts (49% ). 4,by extrastimulation at the rightventricular apex, decremental V2H2 interval developed in 127 pts with a definite His potential (H,),whereas,H2A2 intervals kept constant in the 121 out of 127 cases. It showed that decremental retrograde AV conduction didn'toccur at the atrioventricular node or at the fast pathway in pts with DANP, and it is the electrophysiological basis for AVNRT.

关 键 词：房室结双径路 心动过速 室房传导 AVNRT 电生理 

分 类 号：R541.760.4[医药卫生—心血管疾病]