室房逆传与冠状动脉病变相关性的探讨

Evaluation of Ventrioatrial Conduction in Patients With Coronary Lesions

比较冠状动脉狭窄与冠状动脉正常者 ,其房室传导系统房室顺传及室房逆传的电生理特征。选择行冠状动脉造影术者 10 3例 ,其中男 5 8例、女 4 5例 ,年龄 6 4 .7± 9.6 (4 8～ 78)岁。根据冠状动脉造影结果分两组 ,管腔直径狭窄≥ 5 0 %者为Ⅰ组 ;<5 0 %者为Ⅱ组。分别作心房和心室刺激 ,观察其房室 (经房室结 )顺传及室房逆传的电生理特征。结果 :Ⅰ组 78例 (75 .7% ) ;Ⅱ组 2 5例 (2 4 .3% )。两组患者房室顺传文氏点均≥ 15 0次 /分 ,无显著差异 (P〉0 .0 5 ) ;仅 8例 (Ⅰ组 6例、Ⅱ组 2例 )有室房 (经房室结 )逆传 (7.8% ) ,两组室房逆传发生率相似 ,无显著差异 (P〉0 .0 5 ) ;其室房逆传文氏点≤ 130次 /分 ;Ⅰ组中 6例有室房逆传者与 72例无室房逆传者的冠状动脉病变部位相似 ,无显著差异 (P〉0 .0 5 )。结论 :在体房室结固有逆传功能明显低于房室顺传 ,或呈单向传导 ,与冠状动脉病变部位无关。

To evaluate the electrophysiological characteristics of antrograde and retrograde atrioventricular node conduction in the patients with or without coronary artery stenosis. Coronary angiography was performed in 103 patients, 58 males, 45 fem ales, age 64.7±9.6(48～78)years. They were divided into two groups based on the resu lt of coronary angiography: Group Ⅰ with the diameter of stenosis ≥50%, Group Ⅱ with the diameter of stenosis <50%. Atrial and ventricular stimulations were performed to observe the electrophysiological characteristics of atrioventricular and ventrioatrial cond uction during coronary angiography. Results: Wenckeback point of atrioventricular conduction was over 150 beat per minute (bpm) in both groups, without significa ntly difference(P〉0.05). Only 8 cases (6 from Group Ⅰ, 2 from Group Ⅱ ) (7 .8%) had retrograde AV node conduction in both groups, but the Wenckeback point was below 130 bpm.The locations of coronary artery lesions in patients (group Ⅰ) with ve ntrioatrial conduction are similar to those in patients (group Ⅱ) without ventr ioatrial conduction. Conclusions: The intrinsic ventrioatrial conduction ability is poor, representi ng unidirectional conduction in majority of cases and bearing no relation to the c oronary artery stenosis.