伴连续性房室结功能曲线的房室结折返性心动过速的电生理分析

Electrophysiological analysis of atrioventricular nodal reentrant tachycardia with continuous atrioventricular node function curves/

目的:探讨无房室结双径路特性的房室结折返性心动过速(AVNRT)的电生理特点。方法:所有心动过速患者射频消融前常规行心内电生理检查。结果:845例射频病人中325例为AVNRT,其中有21例患者房室结功能曲线呈连续性,其电生理特征:希氏束图上心房回波(A)先出现,A波落在室波升支或其前,希氏束不应期内刺激心室,不能提前夺获心房,射频消融后心房刺激时AHmax明显缩短。结论:伴连续性房室结功能曲线的AVNRT患者心房刺激不表现房室结双径路的电生理特性,其消融终点初步定为:心房心室S1S1、S1S2刺激不诱发AVNRT;无AH/VH传导曲线跳跃;房室结前传不应期明显缩短。

Objective: To explore the electrophysiological features in atrioventricular nodal reentrant tachycardia (AVNRT) with continuous atrioventricular node function curves. Methods: The electrophysiological study was performed in all subjects before radio frequency catheter ablation (RFCA). Results:A total of 325 cases of AVNRT were found from 845 cases with RFCA, among which 21 cases were confirmed with continuous atrioventricular node function curves. The electrophysiological features including: Atrial echo wave (A) preceded in bundle diagram, A wave located in or before ascending branch of ventricular wave (V); ventricular stimulation with in the effective refractory period can't capture atrium ahead, and AHmax shortened obviously while atrial stimulation undergoing after RFCA. Conclusion: The electrophysiological features of dual atrioventricular nodal path not appear in AVNRT cases with continuous atrioventricular node function curves. Successful ablation is defined as that: AVNRT will not be induced by atrial or ventricular S1S1, S1S2 stimulation, there is not jump in AH/VH conduction curve, the AHmax shortened significantly.