房室折返性心动过速RP’时距的特征及对旁道定位的意义

THE CHARACTERISTICS OF RP' INTERVALS AND THE VALUE OF ACCESSORYPATHWAY LOCALIZATION IN PATIENTS WITH ATRIOVENTRICULAR RECIPRO-CATING TACHYCARDIA

应用食管调搏，检测６４例旁道（ＡＰ）参与的房室折返性心速患者Ⅰ、Ⅱ、Ｖ＿１和食管导联的室房时距（ＲＰ’）、Ｐ＿（ｖ１）Ｐ＇＿Ｅ和△ＲＰ’时距（ＲＰ＿（Ｖ１）与ＲＰ’＿Ⅰ之差）。发现左侧ＡＰ者ＲＰ＿Ⅰ较ＲＰＶ１短（Ｐ＜０．０１），而右侧ＡＰ时较ＲＰＶ＿１长（Ｐ＜０．０１）；无论ＡＰ位于何侧心腔，ＲＰ＇＿Ｉ与ＲＰ＇＿Ｅ、△ＲＰ’和ＰＶ＿１－Ｐ＇＿Ｅ时距均基本相等（Ｐ＞０．０５）；两侧ＡＰ＿Ⅱ时距无差异（Ｐ＞０．０５）。提示测量Ｒ’＿Ⅰ和ＲＰ＿（Ｖ１）时距有助于区分左右ＡＰ；Ｐ＇＿Ⅰ和Ｐ’Ｅ相同，也主要反映了左房除极，在ＡＰ定位时，△ＲＰ’和Ｐ’＿（Ｖ１）－Ｐ’＿Ｅ时距有同等的意义；Ｐ’Ｉ并不特定表示某一侧心房除极，ＲＰ＇＿Ⅱ与ＡＰ的左右位置无关。

The RP' interval in leads I ,ll and V1 and esophageal lead,Pv1-1P'E andRP' intervals in64 patients with tachycardia utilizing retrograde accessory pathway (AP) were measured after the tachy-cardia were induced by esophageal pacing.The-RP,interval was found significantly shorter than RP inter-val in patients with left-sided AP (P<0.01 )and significantly longer in cases with rightsided AP (P<0.01 j. No difference was observed between RP', and RPs intervals (P> 0.5). The bRP' and Pv1-PEintervals were almost equivalence (P>0.21. There was no significant difference in RP1, interval betweenAP of two sides (P>0.53. Our data suggest that RP1 and RPv1 intervals are usful indicators to distin-guish left frorn right-sided AP,P'I reflected depolarization of the left atrium, and the ARP' interval hasthe same significance as Pv1-PE interval,while RP1, interval is not related to localization of left or right-sided AP.