经食管心脏电生理检查与腔内电生理检查对室上性心动过速的诊断价值对比  

Comparison of diagnostic value on supraventricular tachycardia between transesophageal electrophysiologic study and intracardiac electrophysiologic study

作　　者：党成晶 刘洪满 向兵 陈皓[4] 刘明[1] 惠杰[1] DANG Chengjing;LIU Hongman;XIANG Bing;CHEN Hao;LIU Ming;HUI Jie(Department of Cardiovascular Medicine,the First Affiliated Hospital of Soochow University,Suzhou Jiangsu 215006;Department of Heart Function,Tai’an Central Hospital Affiliated to Qingdao University,Qingdao Shandong 271000,China;Department of Cardiopulmonary and Vascular Disease,Tai’an Central Hospital Affiliated to Qingdao University,Qingdao Shandong 271000,China;Taishan Medical Care Center,Tai’an Central Hospital Affiliated to Qingdao University,Qingdao Shandong 271000,China)

机构地区：[1]苏州大学附属第一医院心血管内科,江苏苏州215006 [2]青岛大学附属泰安市中心医院心功能科,山东青岛271000 [3]青岛大学附属泰安市中心医院心肺血管病科,山东青岛271000 [4]青岛大学附属泰安市中心医院泰山医养中心,山东青岛271000

出　　处：《实用心电学杂志》2023年第4期265-268,共4页Journal of Practical Electrocardiology

基　　金：苏州市科技计划项目(SLC201907)。

摘　　要：目的探讨经食管心脏电生理检查(transesophageal electrophysiologic study,TEEPS)与腔内电生理检查(intracardiac electrophysiologic study,IEPS)对室上性心动过速(supraventricular tachycardia,SVT)的诊断价值。方法对197例采用TEEPS诱发、终止SVT的患者行IEPS,并对结果进行对比分析。结果将IEPS诊断结果作为SVT诊断的金标准,验证TEEPS诊断的准确性。TEEPS对房室结折返性心动过速(atrioventricular nodal reentrant tachycardia,AVNRT)的诊断准确率为97.1%,房室折返性心动过速(atrioventricular reentrant tachycardia,AVRT)诊断准确率为94.1%,房性心动过速(简称房速)诊断准确率为100%。TEEPS和IEPS对AVNRT的检出率分别是73.2%、72.3%,对AVRT的检出率均为26.7%,二者比较差异无统计学意义(P>0.05)。除房速外,患者自发或TEEP检查过程中诱发出的心动过速均能经食管心房调搏终止。结论TEEPS在明确SVT机制、定位房室旁道以及终止心动过速方面有较高的应用价值。TEEPS作为射频消融术前的常规筛查手段,可缩短手术时间、减轻手术创伤及经济负担。Objective To investigate the value of transesophageal electrophysiologic study(TEEPS)and intracardiac electrophysiological study(IEPS)in diagnosing supraventricular tachycardia(SVT).Methods IEPS was performed in 197 patients who had undergone TEEPS to induce and terminate SVT.The results were comparatively analyzed.Results IEPS diagnosis results are considered as the gold criteria for SVT,and applied to verify the diagnostic accuracy of TEEPS.By TEEPS,the diagnostic accuracy rate of atrioventricular nodal reentrant tachycardia(AVNRT)is 97.1%,the diagnostic accuracy rate of atrioventricular reentrant tachycardia(AVRT)is 94.1%,and the diagnostic accuracy rate of atrial tachycardia(AT)is 100%.The detection rate of AVNRT by TEEPS and IEPS are separately 73.2%and 72.3%while the detection rate of AVRT by TEEPS and IEPS are both 26.7%,without statistically significant differences(P>0.05).Spontaneous or stimulation induced tachycardia during TEEPS could be terminated by transesophageal atrial pacing except for AT.Conclusion TEEPS has a relatively high application value in the determination of SVT mechanism,location of atrioventricular accessory bypass and termination of tachycardia.As a routine screening tool before radiofrequency ablation,TEEPS is capable of shortening operation time,and reduce operation trauma and economic burden.

关 键 词：经食管心脏电生理检查 室上性心动过速 腔内电生理检查 射频消融 经食管心房调搏 

分 类 号：R541.75[医药卫生—心血管疾病] R540.4[医药卫生—内科学]