房室结双径路88例分析  

A Data Analysis of 88 Patients with Dual Atrioventricular Nodal Pathways

作　　者：赵宁[1,2] 刘仁光[3] 

机构地区：[1]贵州省人民医院 [2]贵州省心血管病医院心电图室,贵州贵阳550002 [3]辽宁医学院心研所,辽宁锦州121001

出　　处：《辽宁医学院学报》2010年第4期324-326,349,共4页Journal of Liaoning Medical University (LNMU) Bimonthly

摘　　要：目的探讨房室结双径路的临床和电生理表现及可能机制。方法对202例因心动过缓和心动过速行食管心房调搏诊断的88例房室结双径路（Diagnosisandtreatmentofthedoubleatrioventricularnodepathway，DAVNP）患者进行临床和电生理检查资料分析。结果1、临床特点：该组资料DAVNP检出率为43．6％；器质性心脏病组为44．5％，元器质性心脏病组为43．O％（P〉0．05）；心动过速组检出率为53．7％，心动过缓组为31．3％（P〈0．01）。2、心房调搏表现：88例出现S2R间期延长〉50m8（50～240ms）突跃现象；5例在同一频率1：1下传中出现相邻SR间期差≥50ms的两种SR间期；9例记录到跳跃式文氏周期。结论房室结双径路是一常见电生理现象；在心动过速DAVNP检出率高，与AVNRT是SVT的常见类型有关；心动过缓常伴迷走神经张力增高，有助DAVNP显露。Objective To explore the clinical and eleetrophysiological manifestation of dual atrioventricular nodal pathways. Methods By analysing the clinical and electrophysiological examination data of 202 patients with dual atrioventrieular node pathways （DAVNP） who were given transesophageal atrial pacing because of bradycardia or tachycardia. Results （ 1 ） Clinical features： the detection rate of DAVNP in the 202 patients was 43.6%, 44. 5% for the group of organic heart disease and 43.0% （P〉0. 05） for the group of nonstruetural heart disease; the detection rate of DAVNP in the group of tachycardia was 53.7%, and 31.3% （P〈0. 01 ） for the bradycardia group. （2） The manifestation of transesophageal atrial pacing： it occurred that S2R interval prolongation〉 50 ms （50 ~ 240 ms） Jumping phenomenon in the 88 cases; two kinds of SR interval （the difference of adjacent SR interval ≥ 50 ms） appear in the 5 eases of 1 ： 1 downloading in the same frequency ; and jumping Wenckebach period was recorded in 9 cases. Conclusions Dual atrioventricular node pathway is a common electrophysiological phenomenon; the detection rate is higher in the group of tachyeardia than bradyeardia, because AVNRT is a common type of SVT; bradycardia will help detact DAVNP, because it is often accompanied by increased vagal tone.

关 键 词：房室结双径路 心动过速 心动过缓 食管心房调搏术 心电图 

分 类 号：R540.4[医药卫生—心血管疾病]