食管电生理P_(V_1)-P_E和R-P_E对室上性心动过速的诊断价值  

Diagnostic value of P_(V_1)-P_E and R-P_E in esophageal elec-trophysiology for supraventricular tachycardia

作　　者：马虹[1] 吴素华[1] 王业松[1] 柳俊[1] 何建桂[1] 唐安丽[1] 廖新学[1] 吴书林[2] 郑祥生[2] 杨平珍[2] 

机构地区：[1]中山医科大学附属第一医院心内科,510080 [2]广东心血管病研究所心内科

出　　处：《心电学杂志》1997年第2期66-68,70,共4页Journal of Electrocardiology(China)

摘　　要：以射频消融成功确诊室上性心动过速类型的48例病人作为对照,探讨食管电生理检查中P_V_1-P_E、R-P_E的诊断价值。结果显示:(1)室上性心动过速的左侧旁道组19例(95％)P_E领先,呈左侧偏心性心房激动,右侧旁道组11例(91.7％)Pv_1领先,呈右侧偏心性心房激动,房室结折返组P_V_1与P_E几乎同时出现,呈中心性心房激动。(2)3组P_V_1-P_E与心内电生理右左心房激动时差△A差异均无显著意义(P>0.05),两者均呈直线相关;3组R-P_E均大于心内电生理室房激动时差V-A(P<0.01),两者均呈直线相关。(3)根据P_V_1-P_E(绝对值)>25ms、R-P_E>100ms诊断正向型房室折返性心动过速,根据P_V_1-P_E(绝对值)≤25ms、R-P_E≤100ms诊断慢-快型房室结折返性心动过速均有很高的敏感性、特异性和准确性。认为食管电生理P_V_1-P_E和R-P_E在室上性心动过速的诊断中有重要价值。Diagnostic value of PV1-PE and R-PE in 48 cases with supraventricular tachycardias that were confirmed by successful radiofrequency ablation were studied by esophageal electrophysiology. Subjects were classified into 3 groups: left-sided accessory pathway group, right-sided accessory pathway group and A-V nodal reentrant group. Results showed that: (1) During supraventricular tachycardia, in left-sided accessory pathway group. PE preceded Pv in 19 cases (95%); while in right-sided accessory pathsway group. Pv1 preceded PE in 11 cases (91. 7%). (2) In all these 3 groups, PV1-PE had no signifiant difference as compared with interval of atrial activation (△A) in intracardiac electrophysiology ( P > 0. 05 ), and linear correlations between Pv1-PE and AA were showed; R-PE longer than V-A intervals (V-A) in intracardiac electrophysiology ( P <0. 01) and linear correlations between P-RE and V-A were showed, too. (3)For the diagnosis of ortho-dromic A-V reentrant tachycardia or slow-fast AV nodal reentrant tachycardia. there were very high sensitivity, specificity and diagnostic accuracy when cut-points of Pv,-PE>25ms, R-PE>100ms or Pv1-PE≤25ms, R-PE≤100ms were used, respectively. These results show important value of Pv1-PE and R-PE in esophageal electrophysiology for diagnosis of supraventricular tachycardia.

关 键 词：食管电生理 心内电生理 心动过速 诊断 

分 类 号：R541.710.4[医药卫生—心血管疾病]