房室结折返性心动过速伴2:1房室阻滞的机制初探  

Preliminary study on the mechanism of 2:1 atrioventricular block during atrioventricular node reentrant tachycardia

作　　者：施广飞[1] 徐伟[1] 吉文庆[1] 余洪松[1] 曹巧兰[1] 

机构地区：[1]南京大学医学院附属鼓楼医院心脏科,210008

出　　处：《中国介入心脏病学杂志》2002年第1期19-22,共4页Chinese Journal of Interventional Cardiology

摘　　要：目的 本研究探讨电生理检查时诱发的房室结折返性心动过速（AVNRT）伴2:1AVB的机制和阻滞部位。方法 回顾分析电生理检查中遇到的9例AVNRT伴2:1AVB患者的资料。结果4例希氏束记录不全的不作分析,其余5例患者中,3例在阻滞的激动上见到H波,在发生AVNRT伴2:1AVB起始阶段出现H-V文氏传导阻滞伴LBBB或RBBB,另外2例在阻滞的激动上未见H波,但有一例2:1AVB过程中突然出现一次H-V3:1文氏传导阻滞。结论 电生理检查诱发的AVNRT伴2:1AVB可能是功能性的希-浦系统阻滞。Objective The purpose of this study was to clarify the mechanism of 2:1 atrioventricular block (AVB) during AV node reentrant tachycardia (AVNRT) induced during electrophysioloic study.Methods In consecutive patients with AVNRT referred for electrophysiologic study, the data of 2 : 1 AVB during induced AVNRT was retrospectively analysed. Results The data of 4 patients was excluded from analyzing because of the unsatisfactory recording of His bundle potential during AVNRT. A His bundle deflection was present in the blocked beats in three of the remaining 5 patients and absent in the other two. At the beginning of AVNRT induced in those patients whose His bundle deflection was present in the blocked beats, H-V Wenckebach sequence with a QRS pattern of RBBB or LBBB was seen preceding and following the 2 : 1 AVB. A pattern of H-V Wenckebach phenomenon occurred once during AVNRT with 2:1 AVB in one of the two patients whose His bundle deflection was absent in the blocked beats.Conclusion The induced 2:1 AVB during AVNRT is due to functional block in the His-Purkinje system regardless of the presence or absence of a His bundle deflection in blocked beats.

关 键 词：房室结折返性心动过速 房室传导阻滞 电生理检查 

分 类 号：R541.710.2[医药卫生—心血管疾病] R541.76[医药卫生—内科学]