房室折返性心动过速的重整现象  

Resetting phenomena of atrioventricular reentrant tachycardia

作　　者：洪江[1] 郭继鸿[1] 李学斌[1] 张萍[1] 许原[1] 易忠[1] 陈冰[1] 孙宝贵[2] 

机构地区：[1]北京大学人民医院心脏电生理室 [2]上海交通大学附属第一人民医院心内科

出　　处：《临床心血管病杂志》2006年第8期451-455,共5页Journal of Clinical Cardiology

摘　　要：目的:探讨房室折返性心动过速(AVRT)的重整特点及对经典重整概念的质疑。方法:选择41例行射频消融治疗的顺向型AVRT患者,心动过速发作时,在心脏的不同部位进行S2刺激扫描,观察心动过速对S2刺激的重整反应。结果:28例(其中左侧房室旁路19/32例,右侧房室旁路9/9例)经高位右房AS2刺激可以使心动过速重整,39例(其中左侧房室旁路30/32例,右侧房室旁路9/9例)经右心室VS2刺激可以使心动过速重整。其中8例左侧旁路患者从左心房、左心室刺激均能发生重整。重整时,偶联间期与回归周期之和(即代偿间歇)与心动过速周长(CL)的关系有3种不同的表现。结论:重整与刺激部位到折返环的距离密切相关;代偿间歇不仅可以小于CL的2倍,也可以大于或等于CL的2倍。Objective： To investigate the characteristics of resetting of atrioventricular reentrant tachycardia （AVRT） and argue classical concept of resetting. Method：S2 stimulus scanning was performed during tachycardia at different sites of the heart and resetting response was observed in 41 cases of AVRT for radiofrequency catheter ablation. Result：Tachycardia was resetted in 28 cases （19/32 using left accessory pathway, 9/9 using right accessory） when premature stimuli were delivered from high right atrium, and in 39 cases （30/32 using left accessory pathway, 9/9 using right accessory pathway） when premature stimuli were delivered from right ventricle. In all the 8 cases using left accessory pathway, tachycardia could be resetted when pacing from left atrium or left ventricle. There were 3 patterns of resetting as to the relationship of the sum of coupling interval and return cycle with 2 times of cycle length. Conclusion： Resetting is closely associated with the distance between the pacing site and reentrant circuit. The sum of coupling interval and returning cycle may not only be less than 2 times cycle length, but be greater than or equal to 2 times cycle length as well.

关 键 词：房室折返性心动过速 心脏电生理学 

分 类 号：R542.1[医药卫生—心血管疾病]