非器质性心脏病的房室传导裂隙现象分析  

Analysis of Gap Phenomenon in Atrioventricular Anterograde From Non-structure Heart Diseases.

作　　者：罗勇[1] 高兴玉[1] 刘小华[1] 向江[1] 陈丽[1] 刘奇玉[1] 

机构地区：[1]川北医学院附属医院心内科,四川南充637000

出　　处：《中国心脏起搏与心电生理杂志》2001年第5期330-332,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：了解非器质性心脏病的患者在作食管电生理检查时裂隙现象发生的情况及类型 ,并观察药物及不同刺激方式对裂隙现象的影响。对在我院作食管电生理检查的 2 2 0例患者 ,先采用S1S2 法 ,每次递减 10ms进行反扫 ,直至S1S2 间期小于 2 0 0ms ,并且连续 3次以上的早搏刺激无下传 ;其中 6 2例患者同时作了S1S2 与S1S2 S3 法检查 ,2 6例用异丙肾上腺素前后行早搏刺激 ,观察裂隙现象的发生情况。 2 2 0例患者中 6 9例患者出现裂隙现象 ,总共 83例次 ,8例有双裂隙 ,裂隙带时限 45 .3± 32 .1(10～ 12 0 )ms;裂隙类型有房室结及结下组织形成的裂隙 42例次、房室结与束支形成的裂隙 2 8例次、束支裂隙 11例次、旁道裂隙 2例 ;房室结双径路的裂隙现象发生率高于其他患者 ;S1S2 法的裂隙现象发生率高于S1S2 S3 法 ;用异丙肾上腺素后的裂隙现象发生率高于用药前。裂隙现象是无器质性心脏病的患者作食管电生理检查时常见的电生理现象 ,它的发生与激动传导径路、早搏刺激的方式和用药有关。In order to investigate the gap phenomenon in atrioventricular(AV) anterograde during cardiac electrophysiological stimulation through transesophageal left atrial pacing,and observe the effect of drug and methods of various pacing to gap.220 cases of non structure heart disease were examined with S 1S 2 programmed pacing until S 1S 2 interval less than 200 ms and three continuous pacing didn′t conducted.Among them,64 cases examed with S 1S 2 and S 1S 2S 3 simutaneously,and 26 cases detected with isoproterenol before and after stimulating.Results:There were 69 cases appeared gap phenomenon and 83 times in total.8 cases had dual gap phenomena.The gap phase duration ranged from 10 to 120 ms(45.3±32.1 ms).The types of gap were AV node(AVN)?under AVN?bundle branch and accessory pathway.The occurring rate of gap was higher in those who had dual atrioventricular nodal pathways(DAVNP) and with S 1S 2 pacing and isoproterenol using.Conclusion:Gap phenomenon in AV anterograde is the common phenomenon during transesophageal cardiac electrophysiological stimulation in non cardiaopathes.It′s appearing relates to DAVNP?drugs and methods of stimulating.

关 键 词：非器质性心脏病 食管调博 裂隙现象 电生理 房室传导 心电图 

分 类 号：R540.41[医药卫生—心血管疾病]