房室结双径路1∶2房室传导的电生理特性  

Electrophysiological features of one to two atrioventricular conduction in dual AV node pathway

作　　者：任自文[1] 宋有城[2] 罗维[3] 丁燕生[1] 朱俊[2] 周菁[1] 杨俊娟 林文华 

机构地区：[1]北京医科大学第一医院心内科,100034 [2]中国医学科学院中国协和医科大学阜外心血管病医院急诊科 [3]北京电力医院心内科

出　　处：《中华心血管病杂志》2000年第4期251-254,共4页Chinese Journal of Cardiology

摘　　要：目的　总结房室结双径路 1∶2房室传导的电生理特性。方法　分析诱发 1∶2房室传导的条件 ;测定患者的基础AH、HV、心房有效不应期、房室结快径有效不应期、快慢径传导时间之差等电生理参数 ,与无 1∶2传导者对比分析。结果　 11例有 1∶2传导者基础AH 5 0～ 80 (6 0 9± 7 0 )ms,HV 35～ 40 (38 6± 2 3)ms;心房有效不应期 130～ 2 40 (194 5± 31 4)ms,与对照组差异无显著性 ;房室结快径有效不应期 7例短于 2 2 0ms,其他 5例分别为 40 0、380、32 0、2 80、2 40ms。快、慢径传导时间之差为 30 0～ 740 (4 99 0± 12 1 8)ms,显著大于对照组。房性早搏、心房期前刺激、心房快速刺激、窦性搏动、房室结多径路发生房室结折返性心动过速时以及心室期前刺激等 6种方式可诱发 1∶2房室传导。结论　房室结远端共同传导通路的不应期短于快、慢径传导时间之差 ,是发生 1∶2房室传导的必要条件。Objective To summarize the electrophysiological features of one to two atrioventricular conduction in dual AV node pathway. Methods Analyzing the conditions in which 1∶2 atrioventricular conduction occurred and measuring the basic AH, HV, atrial effective refractory period, effective refractory period of fast pathway of atrioventricular node and difference of conduction time between fast and slow pathways in the cases with 1∶2 atrioventricular conduction and compare them with those cases without 1∶2 atrioventricular conduction. Results Basic AH was 50-80 (60 9±7 0)ms, HV was 35-40 (38 6±2 3) ms; atrial effective refractory period was 130-240 (194 5±31 4) ms in 11cases with 1∶2 atrioventricular conduction, there were no significant differences as compared to those cases without 1∶2 atrioventricular conduction; the effective refractory periods of fast pathway of atrioventricular node were less than 220 ms in seven patients and were 400, 380, 320, 280, 240 ms, respectively, in remainders. The difference of conduction time between fast and slow pathways was 300-740 (499 0±121 8) ms, which was significantly longer than that of controls and also longer than the effective refractory period of fast pathway in the same group. One to two atrioventricular conduction could be induced by atrial premature beat, atrial extrastimulus, atrial burst pacing, sinus beat, ventricular premature stimulus and also occurred during atrioventricular node reentrant tachycardias in multiple atrioventricular node pathway. Conclusion The prerequisite for 1∶2 atrioventricular conduction is that the difference of conduction time between fast and slow pathways is longer than the effective refractory period of distal common pathway of atrioventricular node.

关 键 词：室上性心动过速 房室结双径路 房室传导 电生理 

分 类 号：R541.7[医药卫生—心血管疾病]