经食管心房调搏终止室上性心动过速的影响因素  

Influencing factors of terminating supraventricular tachycardia by esophageal atrial pacing

作　　者：张炜鑫 王新康[1,2] 高洁[1,2] ZHANG Wei-xin;WANG Xinkang;GAO Jie(Department of Electrocardiogram Diagnosis,Fujian Provincial Hospital,Fuzhou Fujian 350001;Provincial Clinical College,Fujian Medical University,Fuzhou Fujian 350001,China)

机构地区：[1]福建省立医院心电诊断科,福建福州350001 [2]福建医科大学省立临床医学院,福建福州350001

出　　处：《实用心电学杂志》2021年第6期408-411,共4页Journal of Practical Electrocardiology

基　　金：国家自然科学基金资助项目(61971140);福建省卫生教育联合攻关项目(2019-WJ-18)。

摘　　要：目的探讨经食管心房调搏(transesophageal atrial pacing,TEAP)终止室上性心动过速(supraventricular tachycardia,SVT)的影响因素。方法选择行TEAP时发生SVT并通过超速抑制终止的患者78例,按终止脉冲数分为脉冲数≤5个组(41例)和脉冲数>5个组(37例)。比较两组患者的年龄、性别、输出电压、插管深度、心动过速类型及频率、终止频率、频率差值、SR延长间期、文氏阻滞点、2∶1阻滞点对终止SVT的影响。结果脉冲数>5个组的心动过速频率、终止频率明显高于脉冲数≤5个组(P<0.05)。二元Logistic回归分析证实,心动过速频率是TEAP终止SVT的影响因素(OR=1.03,P=0.02)。心动过速频率越快,超速刺激需要的脉冲数越多。结论心动过速频率对TEAP终止SVT的脉冲发放次数有重要影响,临床操作时应予以密切关注。Objective To investigate the factors influencing the termination of supraventricular tachycardia(SVT)by transesophageal atrial pacing(TEAP).Methods We selected 78 patients in whom SVT occurring during TEAP had been terminated by overspeed suppression.They were divided into pulse number≤5 group(41 cases)and pulse number>5 group(37 cases)according to the number of termination pulses.We compared potential factors’influence on the termination of SVT between the two groups,and these factors included age,sex,output voltage,depth of intubation,type and frequency of tachycardia,termination frequency,frequency difference,SR prolonged interval,Wenckebach block point and 2∶1 block point.Results The tachycardia and termination frequency in the pulse number>5 group are significantly higher than those in the pulse number≤5 group(P<0.05).Bivariate Logistic regression analysis confirms that tachycardia frequency is the influencing factor for the termination of SVT by TEAP(OR=1.03,P=0.02).The faster the tachycardia frequency is,the more pulses are needed for overspeed stimulation.Conclusion The frequency of tachycardia has an important influence on the number of released pulses for terminating SVT by TEAP,which should be paid close attention to in clinical operation.

关 键 词：室上性心动过速 心动过速 经食管心房调搏 超速抑制 

分 类 号：R541.71[医药卫生—心血管疾病]