食管心房调搏在阵发性心动过速电生理检查中的地位

Value of esophageal pacing in studies on paroxymal tachycardia

为评价食管心房调搏(TEAP)在阵发性心动过速电生理检查中的地位,用TEAP检查273例阵发性心动过速,其中267例室上速诱发266例(99.3%),2例室速(2/6)复制成功;所诱发持续性心动过速均被终止.经与心内标测和射频消蚀对照,结果:(1)检出室上速264例(诊断阳性率98.2%),单旁道184例(阳性率100%),双旁道4例(阳性率57.1%).(2)86例隐(?)性旁道术前左右定位的符合率100%,其中41例正确地预测了旁道的具体部位.提示:除多发性旁道外,TEAP对室上速检查的准确率与心内标测相近,其结果对射频消蚀病例选择和术中指导均有意义.

To investigate value of esophageal electrophysiologic investigation in studies on paroxymal tachycardia, esophageal stimulation was performed in 273 patients with paroxymal tachycardia. Sustained and transient tachycardia were induced in 266 of 267 (99. 3%) patients with supraventricular tachycardia (PSVT) and 2 of 6 cases with ventricular tachycardia. The sustained tachycardia(>30 second) was completely stopped. Results compared with those in intracardiac electrophysiologic investigation and ra-diofrequency ablation showed that: (1)264 cases of PSVT (98. 2%), 184 patients with single accessory pathway (AP) (100. 0%) and 4 cases with dual AP (57. 1%) were recognized. (2) 100. 0 % of right or left-side location was confirmed in 86 patients with concealed accessory pathway (CAP) and the exact site was predicted correctly in 41 cases. In conclusion, except for multiple AP, study on PSVT by esophageal electrophysiological investigation could be as accurate as that of invasive techniques. It is helpful in selecting patients before operation and in guide ablation of CAP.