射频消融术前行经食管心房调搏检查的临床意义  

The value of transesophageal atrial pacing before radiofrequncy catheter ablation in patients with paroxysmal supraventricular tachycardia

作　　者：郑方胜[1] 刘松[1] 辛辉[1] 

机构地区：[1]青岛大学医学院附属医院,山东青岛266003

出　　处：《山东医药》2003年第4期15-17,共3页Shandong Medical Journal

摘　　要：选取初步诊断为阵发性室上性心动过速 ( PSVT)欲行射频消融 ( RFCA )的患者 3 2 8例 ,在做 RFCA之前均先行经食管心房调搏 ( TEAP)检查。在检查过程中 ,每例患者均诱发出心动过速 ,在心动过速时应用多导心电图 ( ECG)同时记录 ,并通过 TEAP时多导 ECG标测资料与心内电生理资料进行对比观察 ,找出 TEAP检查对PSVT的诊断规律并对其进行评价。结果本组 3 2 8例初诊为 PSVT患者在行 TEAP检查之后均做了心内电生理检查并且射频消融均获成功 ;其中 3 16例 TEAP诊断与心内电生理及射频消融结果符合 ,TEAP与心内电生理符合率为 96.4%。 TEAP 12例不符合诊断病例 ,其诊断错误主要由于 P波记录不清、RP标测不准确及不能做心室起搏观察室房逆行传导等局限性造成。认为在 PSVT射频消融手术之前行 TEAP电生理检查 ,可初步了解PSVT性质、分类 ,明确诊断 ,简化射频消融操作手续 ,缩短手术时间 ,减少患者痛苦 ,降低放射线照射的损害等优点 。To determine the value of transesophageal atrial pacing(TEAP)before radiofrequency catheter ablation(RFCA)in patients with paroxysmal supraventricular tachycardia(PSVT),328 patients with PSVT underwent TEAP before RFCA.Tachycardia was induced and electrocardiogram recording was performed with synchronized multileads in each patient during TEAP.The results showed after TEAP,328 patients with PSVT underwent endocardial electrophysiological study and RFCA successfully.The diagnostic result of TEAP was consistent with that of endocardial electrophysiological study in 316 patients(96.4%).The reasons of misdiagnose in the other 12 patients were unclear recording of P wave,inaccurate measurement of RP interval,and unable to observe ventriculoatrial(VA)conduction by ventricular pacing.These suggested performing TEAP before RFCA in patients with PSVT could find out the character and classification of PSVT initially,simplify the process of RFCA,shorten operation time,decrease patients'pain,and reduce exposure time and damages of X-ray.This method could be applied in the clinical practice.

关 键 词：经食管心脏起搏 身频消融 阵发性室上性心动过速 

分 类 号：R541.71[医药卫生—心血管疾病]