食管心房调搏终止室性心动过速的初步探讨

Termination of ventricular tachycardia by trans-esophagcal atrial pacing

目的:总结15例经食管心房调搏,成功终止室性心动过速的经验与体会.方法:选择15例室性心动过速病人,予以食管心房调搏,先后用分级递增和连续递增两种刺激方式予以刺激,刺激电压为25～30V,对难以终止者,静脉注射异搏定,再予以经食管心房调搏.结果:单纯采用分级递增法终止了10例患者的室速,2例患者需加用连续递增法才能终止,另3例患者经上述两种方式均未成功,给予异搏定5mg静脉注射后以分级递增法才终止了室速.结论:经食管心房起搏可以部分地成功终止持续性室性心动过速,减少直流电复律应用的必要性.

Objective: To report the successful termination of ventricular tachycardia (VT) by trans-esophageal atrial pacing in 15 patients with ventricular tachycardia (VT). Methods: VT was proven by 12 leads surface ECG and trans-esophageal single lead ECG during the tachycardia. Using incremental pace (IP) and ramp pace (RP) to terminate the tachycardia. The pacing voltage ranged 25-30 V. Results: VT was successfully terminated in 10 patients with IP and 3 patients with RP. Both IP and RP failed to terminate the VT in 2 cases at first; VT was then terminated by IP after intravenous injection of 5 mg verapamil. Conclusion: It is demonstrated that trans-esophageal atrial pacing can successfully terminate some of VT and thus avoid the necessity for direct current cardioversion.