经食管心房调搏中房室结折返性心动过速的诱发因素分析  

Analysis on inducing factors of atrioventricular nodal reentrant tachycardia in transesophageal atrial pacing

作　　者：陈辉 楚咏晗 康锐 杨丽红 徐金义[3] CHEN Hui;CHU Yonghan;KANG Rui;YANG Lihong;XU Jinyi(Department of Cardiac and Brain FunctionXinyang Central Hospital,Xinyang Henan 464000;Department of Cardiovascular Medicine,Xinyang Central Hospital,Xinyang Henan 464000;Department of Cardiopulmonary Function,Henan Provincial People s Hospital,Zhengzhou Henan 450003,China)

机构地区：[1]信阳市中心医院心脑功能科,河南信阳464000 [2]信阳市中心医院心血管内科,河南信阳464000 [3]河南省人民医院心肺功能科,河南郑州450003

出　　处：《实用心电学杂志》2021年第1期24-27,31,共5页Journal of Practical Electrocardiology

基　　金：郑州市科技局重点科研资助项目(KK201700005)。

摘　　要：目的探讨经食管心房调搏(transesophageal atrial pacing,TEAP)检查中诱发房室结折返性心动过速(atrioventricular nodal reentrant tachycardia,AVNRT)的因素。方法随机抽取接受TEAP检查的163例患者进行回顾性研究,心内电生理检查均可诱发AVNRT,但TEAP共诱发出92例AVNRT(观察组),未诱发出AVNRT或其他心律失常71例(对照组)。在600 ms的基础起搏间期(S 1 S 1间期)下,测量PR间期和房室结有效不应期;在程序心房S 1 S 2刺激或频率递增S 1 S 1刺激下,测量最长的SR间期(SR延长间期)和房室文氏传导时最长的S 1S 1间期(文氏周期);记录性别、年龄数据。采用单因素和多因素分析,探讨AVNRT的诱发因素。结果二元Logistic回归分析证实,性别(OR=0.252,P=0.030)、SR延长间期(OR=1.052,P<0.01)及文氏周期(OR=0.938,P<0.01)是诱发AVNRT的独立危险因素,其预测准确率达92.6%。结论性别、SR延长间期和文氏周期可作为TEAP检查中诱发AVNRT的预测因素,具有较高的临床应用价值。Objective To investigate the factors of inducing atrioventricular nodal reentrant tachycardia(AVNRT)during transesophageal atrial pacing(TEAP)examination.Methods A total of 163 patients undergoing TEAP examination were randomly selected for retrospective study;AVNRT was induced by cardiac electrophysio-logical examination.However,AVNRT was induced by TEAP in 92 patients(observation group)while AVNRT or other arrhythmias failed to be induced in 71 patients(control group).Setting the basic pacing interval(S 1S 1 interval)as 600 ms,we measured PR interval and effective refractory period of atrioventricular node;given programmed atrial S 1S 2 stimulation or frequency-increasing S 1S 1 stimulation,we also measured the longest SR interval(SR prolonged interval)and the longest S 1S 1 interval in atrioventricular Wenckebach conduction(Wenckebach cycle).Data of gender and age were recorded.The inducing factors of AVNRT were explored by univariate and multivariate analysis.Results Bivariate Logistic regression analysis verifies that gender(OR=0.252,P=0.030),SR prolonged interval(OR=1.052,P<0.01)and Wenckebach cycle(OR=0.938,P<0.01)are independent risk factors for AVNRT inducement with a prediction accuracy rate of 92.6%.Conclusion Gender,SR prolonged interval and Wenckebach cycle can be considered as predictive factors for inducing AVNRT during TEAP examination with high value in clinical practice.

关 键 词：经食管心房调搏 心脏电生理检查 房室结折返性心动过速 诱发因素 

分 类 号：R541.71[医药卫生—心血管疾病]