房性心动过速与持续性交界区反复性心动过速的快速鉴别  

Rapid differentiation of atrial tachycardia from permanent junctional reciprocating tachycardia

作　　者：詹贤章[1] 吴书林[1] 李海杰[1] 杨平珍[1] 陈泗林[1] 方咸宏[1] 钱卫民[1] 

机构地区：[1]广东省心血管病研究所心内科,广州510100

出　　处：《中华心律失常学杂志》2000年第2期112-113,共2页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的　初步探讨房性心动过速 (房速 )与持续性交界区反复性心动过速 (perm anentjunctional reciprocating tachycardia,PJRT)快速鉴别方法。　方法　 36例室上性心动过速患者 ,经心内电生理检查 ,其中 30例诊断为房速 ,6例诊断为 PJRT;心动过速时于右心室行 S1 S1 起搏 (S1 S1 间期较心动过速周长短 10～ 40 m s) ,观察心室起搏呈 1∶ 1室房 (VA)传导者停止起搏后即刻心电激动顺序 ,分为“房房室”(AAV)及“房室”(AV)顺序。　结果　右心室起搏时 ,30例房速中 6例为 PJRT,其 VA传导呈1∶ 1,停止起搏后即刻心电激动顺序分别为 AAV及 AV。　结论　提示鉴别房速与 PJRT,心室起搏时VA分离固然有助于前者诊断 ,但对呈 1∶ 1VA传导者 ,观察起搏停止后心电激动顺序 ,具有快速、准确鉴别作用。Objective To explore the rapid differentiation of atrial tachycardia (AT) from permanent form of junctional reciprocating tachycardia (PJRT). Method Thirty six patients with supraventricular tachycardia underwent electrophysiologic study.ATs were induced in 30 cases and PJRTs were diagnosed in 6 cases.Right ventricular pacing (S 1S 1) was initiated at a cycle length 10 to 40 msec shorter than the tachycardia cycle length to observe the electrogram sequence upon cessation of the ventricular pacing associated with 1∶1 ventriculoatrial conduction during tachycardia in each patient.The electrogram sequence immediately after the last ventricular paced complex was categorized as “atrial atrial ventricular” (AAV) or “atrial ventricular” (AV). Result 1∶1 ventriculoatrial conduction during right ventricular pacing was observed in 6 patients with AT and 6 cases with PJRT.The AAV response was recorded in the 6 patients of AT and the AV response was observed in all cases of PJRT. Conclusion This result suggests that VA dissociation in vertricular pacing is useful for the diagnosis of AT,however,the electrogram sequence upon cessation of the pacing allows for the rapid and accurate differentiation of AT from PJRT.

关 键 词：房性心动过速 持续性交界区反复性心动过速 

分 类 号：R541.7[医药卫生—心血管疾病]