经食道心房调搏前后的心肌酶学改变

Change of Myocardial Enzymes Before and After Transesophgeal Atrial Pacing

目前,经食道心房调搏正在广泛地被采用,临床上不仅藉以获知窦房结恢复时间以及窦房传导时间,以建立病态窦房结综合征的诊断,并用为窦房结功能不全所致的缓慢性心律失常的急症处理。

In 18 patients with coronary heart disease, 7 patients with sequelae of viral myocarditis and 25 normal adults, CPK-MB, AST, m-AST, LDH, LDH/LDHwere measured by transesophageal atrial pacemaker before pacing and 8 hours, 48 hours after pacing (coronary heart disease group). The influence of pacing voltagic amplitude in each group on enzyme activity before and after transesophageal atrial pacing were analysed and compared. The results of this study were as foll0ws: (1) Slight abnormality occured in 4 patients with coronary heart disease (4/18) after pacing. The difference in value of enzyme indices between the groups was statistically insignificant, the clinical course and change of the enzyme activity were transient and returned to normal immediately;(2) The relationship between enzyme activity and voltage strength was obscure in this study. It was found that for different special locations and distance between the electrode catheter and the atrium, and different resistance of the interpolating electrode, the output voltage strength of the pacemaker and that really received by the heart were different. It was shown that as the-transesophageal atrial pacing is a noninvasive and simple method, with specifity and fewer side effects and greater safe coefficient, it may be widely used clinically. It must be however, careful for the clinicians to select cases and voltage strength, eapecially in patients with coronary heart disease.