左侧房室旁道左右心室起搏下室房逆传研究  

Study about ventrioatrial Conduction from Left Pathway with Right and Left ventricular pacing

作　　者：张羽坤[1] 郑亚西[2] 叶芸[2] 杨君[2] 杨龙[2] 沈万贵[1] 李茂春[1] 

机构地区：[1]贵州航天医院心血管内科,563003 [2]贵州省人民医院心血管内科,550002

出　　处：《临床心电学杂志》2016年第1期23-29,34,共8页Journal of Clinical Electrocardiology

摘　　要：目的左侧房室旁道患者,射频消融术前于左、右心室心尖部在相同刺激条件下行S1S2早搏刺激至旁道不应期,测量旁道室房传导时间及旁道不应期的相关数据,探讨旁道的逆传特性有何异同。方法选取2011年10月至2012年09月于贵州省人民医院心导管室接受射频消融术的室上性心动过速患者,入选患者经心内电生理检查为左侧房室旁道,射频消融术后心内电生理检查房室结无室房逆传功能者共44例为研究对象。结果不同性别者左、右心室起搏下旁道不应期比较,差异无统计学意义(p>0.4及p>0.4);不同性别者左、右心室起搏下旁道室房传导时间比较,差异无统计学意义(p>0.8及p>0.2)。合并显性房室旁道与单纯隐匿性房室旁道左、右心室起搏下旁道不应期比较,差异无统计学意义(p>0.4及p>0.3);合并显性房室旁道与单纯隐匿性房室旁道左、右心室起搏下旁道室房传导时间比较,差异无统计学意义(p>0.7及p>0.2)。所有患者左、右心室起搏下旁道不应期比较,差异无统计学意义(p>0.5);所有患者左、右心室起搏下旁道室房传导时间比较,差异有统计学意义(p<0.001),且右心室起搏旁道室房传导时间较左心室起搏明显延长。结论左侧房室旁道患者,男女性别之间,旁道不应期及旁道室房传导时间比较无明显差异;合并显性房室旁道与单纯隐匿性房室旁道之间,旁道不应期及旁道室房传导时间比较无明显差异;所有患者左、右心室起搏下旁道不应期比较无明显差异,旁道室房传导时间右心起搏较左心起搏明显延长。Objective Before radiofrequency catheter ablation surgery, the patients, suffering the left atrioventricular accessory pathway, were received the S1S2 premature stimulation to the accessory pathway effective refractory period at left and right ventricular apex, then we measured the time of ventriculoatrial conduction through bypass, the data relating to the accessory pathway effective refractory period and the characteristics of bypass inversion. Methods 44 patients were selected for our research, who were at Cardiac catheterization lab in Gui Zhou Province People＇s Hospital for radiofrequency ablation of supraventricular tachycardia during the October 2011 to the September 2012. They were the left atrioventricular bypass in electrophysiological examination, while now their atrioventricular nodes don＇t have chamber room inverse transfer function through intracardiac electrophysiological examination after radiofrequency ablation. Results There are no statistically significant difference in the bypass refractory period between different genders with ventricular pacing（p〉0.4, p〉0.4）; no statistically significant difference in ventricular atria conduction time through bypass between different genders with ventricular pacing（p〉0.8, p〉0.2）.There are no statistically significant difference in accessory pathway effective refractory period between merge dominant atrioventricular accessory pathway and occult alone with ventricular pacing（p〉0.4, p〉0.3）; no statistically significant difference in ventricular atria conduction time through bypass between merge dominant atrioventricular accessory pathway and occult alone with ventricular pacing（p〉0.7, p〉0.2）. There are no statistically significant difference in accessory pathway effective refractory period during all patients with ventricular pacing（p〉0.5）. There are statistically significant difference in ventricular atria conduction time through bypass during all patients with ventricular pacing（p0.001）, and the ventricular atria

关 键 词：左侧房室旁道 射频消融术 旁道不应期 旁道室房传导时间 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]