心房心室起搏在核素位相分析检出心律失常患者异位激动点中的应用

Application of radionuclide ventriculography phase analysis in patients with atrial or ventricular pacing for detecting ventricular abnormal excitation

对17例预激综合征(WPW)合并阵发性室上性心动过速(SVT)患者以及3例阵发性率性心动过速(VT)患者用心房心室起搏方法诱发其 SVT 及 VT 发作。结果表明,心房心室起搏大大提高了放射性核素位相分析(PA)对旁道与心室异位激动点的检出率。17例 WPW 患者在诱发 SVT 时,PA 对旁道的检出率由诱发前的68.2%增加到95.5%;3例阵发性VT 患者,在诱发 VT 时,PA 均检出心室异位激动点。由此可见,心房、心室起搏对异位病灶的诊断及消融疗效的判断是一种有价值的方法。

PURPOSE The aim of this study was to increase the accuracy of detecting ventricular abnormal excitation. METHODS During atrial or ventricular pacing,radionuclide ventriculography phase analysis (RNV-PA) was performed in 17 pa- tients with Wolff-Parkinson-White (W-P-W) syndrome and paraxysmal supraventricular tachycardia (PSVT) and ventricular tachycardia (PVT).RESULTS During pacing,detection rate of abnormal excitation by RNV-PA was 95.5%,compared with 68.2% during basic conduction.CONCLUSIONS Atrial or ventricular pacing can significantly increase the detection rate of abnor- mal excitation by RNV-PA in patients with W-P-W syndrome.It may be a valuable method for identifying the abnormal excitation and estimating the therapeutic effect of ablation.