长R-P’室上性心动过速(附5例报告)

The long R-P' supraventricular tachycardia

报告在食管电生理检查中发现的5例长R-P＇室上性心动过速.这种心动过速一般包括:①持续性交界性折返性心动过速;②异位房性心动过速;③Ebstein畸形合并附加旁路;④快一慢型AV结内折返性心动过速;⑤隐匿性旁路伴长V-A传导时间.患者室上性心动过速常反复发作,对药物治疗反应极差,需依赖于详细的心内电生理检查确诊.由于多数类型的长R-P＇心动过速可通过手术和消融治愈,因此.对这类心动过速的诊断和鉴别诊断甚为重要.

5 patients with long R-P' tachycardia were found by transesophagus electrophysi-ologic test. The type .clinical and electrophysiologic characters of this form tachycardia described are in this articlel include:①permanent form of junctional reciprocating tacyhcadia(PJRT);②ec-topic atrial tacyhcardia; ③Ebstein's anomaly with an associated atrioventricular pathway ;④ atypical form ('fast-slow' ) of AV node reentry;⑤concealed accessory pathways with long conduction times. These tachycardias are frequently incessant and refractory to pharmacologic therapy. Because four of these five types of long R-P' tachycardia can be selectively ablated by surgery and/or catheter ablation .the differential diagnosis in these rhythms will be very important in clinic. Actually the exact diagnosis only can be founded by careful endocardial electrophysiologic test.