房室结双径路及有关问题的研究

Research into atrioventricular nodal dual pathways and related issues

本文对５３例各种不同类型的心律失常进行了食管电生理检查，共检出房室结双径路２０例。９例有室上性心动过速（ＰＳＶＴ）史，其中４例诱发出ＰＳＶＴ（２０％），并通过超速抑制终止其发作；９例有窦缓史，其中２例经食管电生理检查诊断为病窦。在此类患者中，发现房室结双径路，在国内尚未见报道。经统计学处理，ＰＳＶＴ与窦缓两者的电生理参数除后者窦房结恢复时间显著延长（Ｐ＜０．０１）外，余均无显著差异。作者认为房室结双经路的存在与窦房结功能是否正常无关，并提出房室结双径路与病窦共存的电生理现象。在２０例房室结双径路中还发现多经路５例（２５％），房室传导间隙６例（３０％）。

Fifty-three patients with various types of arrhythmia were examined using transeosophagealatrial pacing. Atrio-ventricular nodal dual pathways were found in 20 patients. Moreover,PSVT was induced in 4 of 9 patients (20%) with history of PSVT and was terminated with hypervelocity. Sick sinus syndrome was detected in 2 of 9 patients with history of sinus bradycardia by transeosophageal atrial pacing.There bas been no report on the presence of atrio-ventricular nodal dual pathways in these patients in China. No significant difference was noted between PSVT and sinus bradycardia in electrophysiological parameters (P≥0.05),except that SNRT was markedly prolonged in sinus bradycardia (P<0.01).The authors concluded that the existence of atrio-ventricular nodal dual pathways showed no connection with normal function of the sinus node and kypothesized that atrio-ventricular nodal dual pathways may coexist with sinus syndrome. Out of 20 cases of atrio-ventricular nodal dual pathways, 5 were found witk multiple pathways (25%),6 with cavity in atrioventricular conduction.