小儿阵发性室上性心动过速的电生理学机制  

Electrophysiologic mechanism of paroxysmal supraventricular tachycardia in children

作　　者：范崇济[1] 张巧芳[1] 李秀英[1] 张宏艳[1] 邢淑华[1] 张莉[1] 

机构地区：[1]天津市儿童医院内科

出　　处：《中华儿科杂志》1997年第7期365-367,共3页Chinese Journal of Pediatrics

摘　　要：为了解阵发性室上性心动过速的产生机制，用心内电生理学方法检查３１例阵发性室上性心动过速（简称室上速）患儿。结果：房室结折返９例，均为慢快型；房室折返共２２例，其中隐匿性附加束１１例，预激综合征１０例，Ｍａｈａｉｍ束１例。异丙肾上腺素和阿托品可使双通道显示，三通道变为双通道并利于室上速的产生。如双通道和附加束同时存在，室上速开始时折返环可以不固定。提示，室上速以房室折返为主，同一病例中可以有不同的折返回路及诱发因素。The aim of this study was to clarify the mechanism of paroxysmal supraventricular tachycardia (PSVI). Thirty one cases underwent intracardiac electrophysiologic investigation. The results showed that 9 had typical atrioventricular nodal reentrant tachycardia and 22 A V reentrant tachycardia including 11 with concealed accessory pathway, 10 with Wolff Parkinson White syndrome and one with Mahaim fibers. Isoproterenal and atropine could unveil dual A V nodal conduction, turn triple to dual A V nodal conduction and facilitate induction of PSVT. In the beginning of PSVT, multiple reentrant circuits could occur if both dual A V nodal and accessory pathways were in the same patient. This study suggests that A V reentry is the most common cause of PSVT and one patient could have different reentrant circuits and factors that facilitate induction of PSVT.

关 键 词：心动过速 室上性 电生理学 儿童 

分 类 号：R725.417.1[医药卫生—儿科]