食管心房调搏对阵发性室上性心动过速发病机制研究

A study of pathogenesis on paroxysmal supraventricular tachycardia through esophagus atrial pacing

使用无创伤性食管心房调搏（TEAP）心电生理检查法，对58例原因不明的阵发性室上性心动过速（PSVT）在非发作期进行程控或非程控心脏刺激，旨在探讨PSVT的发病机制，电生理特征以及TEAP对其临床研究的价值。结果：诱发示PSVT的共47例（折返机制），占81．0％，不能诱发11例（非折返机制），占19．0％。说明折返机制系PSVT的主要发病机制。又根据程控刺激中所表现的不同心电生理特征，47例折返性PSVT又可分为不同机制的折返。其中房室结内折返性23例，房室折返性17例，心房内或窦房折返性7例，说明前两种折返系折返性PSVT的主要折返机制，与国内外报道相似。

Through esophagus atrial pacing (TEAP) is a non-invasive electrocardial phygiolagic examination. By this method, we examined 58 cases of unknown paroxysmal supraventricular tachycardia (PSVT) in non-attack period. The aim was to find their pathogenetic mechanism,electrophysiologic feature and value on TEAP, Conclusion: Among them 47 cases were induced PSVT (reentrant mechanism,81. 0% ),among them 11 cases were not induced PSVT (non-reentrant mechanism, 19. 0 % ) , This showed that reentrant mechanism was PSVT's main pathogenies. According to different electrocardial physiologic feature in programme control stimulation, 47 patients reentrant PSVT were divided into different types again, Among them A-V node reentry (AVN-RT) was 23 cases,A-V reentry (AV-RT) was 17 cases and internal atrial or sinus-atrial reentry was 7 cases. This showed that AVN-RT and AV-RT were reentrant PSVT's main pathogetic mechanism,in accord with internal and external reports.