经食道心房调搏用不同刺激方式诊治阵发性室上性心动过速的对比分析  

Comparative analysis of different stimulation methods for diagnosis and treatment of paroxysmal supraventricular tachycardia by esophageal atrial pacing

作　　者：魏文佳[1] 陈万国[1] 刘婷[1] 孙桂琴[1] WEI Wen-jia;CHEN Wan-guo;LIU Ting;SUN Gui-qin(Department of Electrocardiogram,Meizhou People′s Hospital,Meizhou,Guangdong 514031,China)

机构地区：[1]广东省梅州市人民医院心电图室,广东梅州514031

出　　处：《岭南心血管病杂志》2017年第6期731-733,776,共4页South China Journal of Cardiovascular Diseases

基　　金：梅州市医药卫生科技项目(项目名称:经食道心房调搏用不同方式诊治阵发性室上性心动过速的对比分析;项目编号:2016-B-66)

摘　　要：目的探讨经食道心房调搏不同刺激方式在阵发性室上性心动过速(paroxysmal supraventricular tachy-cardia,PSVT)诊疗中的应用价值。方法选取梅州市人民医院2016年1月1月至2017年8月31日收治的120例PSVT患者作为研究对象。使用随机数字表法分为两组,每组60例。两组在经食道心房调搏中采用不同的刺激方式来诱发或终止PSVT。诱发时观察组应用S1S2程控刺激方式,对照组应用RS2程控刺激;终止时对照组采用超速抑制法,观察组采用亚速抑制法,若终止无效则依次改用猝发脉冲法和程控期前刺激法。分析经食道心房调搏对PSVT的分型诊断准确率,对比不同刺激方式诱发及终止PSVT的效果。结果食道心房调搏诊断的PSVT分型有115例与心内电生理检查结果相符,诊断符合率为95.83%。观察组的PSVT诱发成功率与对照组比较,差异无统计学意义(P>0.05);观察组的PSVT终止有效率显著低于对照组,平均刺激时间显著长于对照组,差异有统计学意义(P<0.05)。观察组经食道心房调搏刺激有25例(41.67%)出现胸骨后灼痛、胸部跳动、心绞痛等副反应,对照组的副反应发生率为88.33%(53/60),组间比较差异有统计学意义(P<0.05)。结论经食道心房调博对PSVT分型的诊断准确性较高,超速抑制对PSVT的终止效果更好,亚速抑制刺激产生的副作用更小。Objectives To explore the application value of different stimulation methods in the diagnosis and treatmentof paroxysmal supraventricular tachycardia(PSVT)by esophageal atrial pacing.Methods Totally20patients withPSVT from January1,2016to August31,2017were treated in Meizhou People′s Hospital and were selected as theresearch objects.The patients were divided into two groups(n=60)using a random number table method.The twogroups were induced or terminated PSVT by transesophageal atrial pacing pulse in different stimulation methods.Obser?vation group used S1S2controlled stimulation and control group used RS2programmed stimulation during inducing.Inthe end,control group was inhibited by the method of over speed inhibition and observation group used sub velocity in?hibition method,if the termination was invalid,than turned to sequentially burst method and programmable stimulatormethod.Accuracy of PSVT typing by esophageal atrial pacing was analyzed and effects of different stimulation methodson the termination of PSVT were compared.Results There were115cases of PSVT classification in the diagnosis ofesophageal atrial pacing and the results were consistent with the electrophysiological examination in the heart with thediagnostic accordance rate was95.83%.There was no significant difference in the PSVT inducing success rate betweenobservation group and control group(P>0.05).PSVT inhibiting success rate in observation group was significantly low?er than that in control group(P<0.05).Average stimulation duration was significantly longer in observation group thanin control group,the difference was statistically significant(P<0.05).There were25cases(41.67%)appeared subster?nal burning pain,chest beating,angina pectoris and other side effects in observation group,while incidence ofside effects was88.33%(53/60)in control group during transesophageal atrial pacing stroke stimulation.There was asignificant difference of incidence of side effects between the two groups(P<0.05).Conclusions Diagnostic accura?cy of PSVT typing by

关 键 词：阵发性室上性心动过速 经食道心房调搏 亚速抑制法 超速抑制法 诊断 

分 类 号：R541.7[医药卫生—心血管疾病]