摘要
Objective To illustrate the automatic modulation of refractoriness of His Purkinje system during atrioventricular nodal reentrant tachycardia (AVNRT) and to discuss the possible mechanisms Methods Programmed electrical stimulations were performed in high right atrium (HRA) in 8 patients with AVNRT before ablation to induce tachycardia and electrocardiagraphic recordings were done synchronically when AVNRT appeared Results All the patients had 2∶1 atrioventricular (A V) conduction when AVNRT began, 2 of whom were blocked below His bundle, 5 above His bundle and 1 unclear After a duration of 14 03±10 03 s of 2∶1 A V conduction, 1∶1 A V conduction with bundle banch block appeared, 3 of which were right bundle branch block (RBBB), 3 left bundle branch block (LBBB), and 2 with both Bundle branch block disappeared after a duration of 6 87±11 26 s Conclusion Effective refractory period (ERP) of His Purkinje system at the beginning of AVNRT was modulated automatically within less than 30-60?s and thus facilitated nodal ventricular conduction The mechanism of this is electrical remodeling
Objective To illustrate the automatic modulation of refractoriness of His Purkinje system during atrioventricular nodal reentrant tachycardia (AVNRT) and to discuss the possible mechanisms Methods Programmed electrical stimulations were performed in high right atrium (HRA) in 8 patients with AVNRT before ablation to induce tachycardia and electrocardiagraphic recordings were done synchronically when AVNRT appeared Results All the patients had 2∶1 atrioventricular (A V) conduction when AVNRT began, 2 of whom were blocked below His bundle, 5 above His bundle and 1 unclear After a duration of 14 03±10 03 s of 2∶1 A V conduction, 1∶1 A V conduction with bundle banch block appeared, 3 of which were right bundle branch block (RBBB), 3 left bundle branch block (LBBB), and 2 with both Bundle branch block disappeared after a duration of 6 87±11 26 s Conclusion Effective refractory period (ERP) of His Purkinje system at the beginning of AVNRT was modulated automatically within less than 30-60?s and thus facilitated nodal ventricular conduction The mechanism of this is electrical remodeling
