房室旁道前向传导特征与潜在危险性的评估

Characteristics of anterograde conduction in atrioventricular accessory pathway and estimation of potential risk.

目的 :估价预激综合征患者房颤发作时发生快速心室反应和室颤的潜在危险性。方法应用经食道心房调搏方法观察房室旁道前向传导功能与房颤发作时最小经旁道下传R -R间期的关系。结果13例患者中10例获得3种以上基础起搏周长 (BCL)下的旁道前向传导有效不应期(APERPa) ,随BCL缩短 ,APERPa依次缩短 ,其中长、短BCL下的APERPa比较有显著性差异(P<0.05)。10例患者经旁道1:1下传心室的最大心房起搏率为168±32.1(115 -210)次/分 ,与短BCL下的APERPa呈明显负相关(r= -0.698,P<0.05)。5例患者经刺激程序诱发出房颤 ,房颤时最短经旁道下传RR间期与经旁道最大1:1下传心房起搏率和短BCL下的APERPa均呈一定程度的相关性(分别r= -0.892,P<0.05 ;r=0.779,P<0.05)。结论旁道前向传导有效不应期和经旁道1:1下传心室的最大心房起搏率与房颤时经旁道下传的最小RR间期有较好的相关性。

Objective: To estimate the potential risk of occurance of ventricular fibrillation during onset of atrial fibrillation(Af) in patient with W-P-W syndrome. Methods: Observing anterograde effective refractory period of accessory pathway(APERPa) in three basic atrial pacing cycle lengths(BCL) and 1:1 conduction rate passing accessory pathway (AP) during atrial pacing. Investigated the relationship between above parameters and minimal RR interval 1:1 conducted through AP during Af. Results:APERPa shortened with decreasing BCL. APERPa and 1:1 conduction rate passing AP correlated with minimal RR interval 1:1 conducted through AP during Af. Conclusion: APERPa and 1:1 conduction rate passing AP can be used to estimate the potential risk on W-P-W syndrome.