房室结逆向传导电生理特点的观察

Electrophysiological characteristics of retrograde conduction through atrioventricular node

目的研究房室结逆向传导的电生理特点。方法分析在我院行电生理检查和／或射频消融的成年患者中电生理资料比较完整的300例患者的房室结逆传电生理特点。结果射频消融术后有161例（54％）有房室结逆传。有逆传患者的前传功能要好于无逆传的患者，对于术后存在室房逆传的患者，逆传功能均明显差于前传功能。射频消融术后有28例（17％）经房室结逆传最早激动冠状静脉窦口，其逆传功能较最早激动希氏束电图的病例相比要差，而两者的前传功能差异无统计学意义。结论射频消融术后54％的患者存在房室结逆传，可能是正常人群中室房逆传的真实反映。有室房逆传患者的房室结前传功能优于无室房逆传者，也优于其本身的逆传功能。房室结逆传冲动进入心房可能存在两条不同的通路。

Objective The aim of this study is to study the electrophysiological characteristics of retro-grade conduction through atrioventricular node. Methods Three-hundred adult patients who had received electrophysiologic study and/or radiofrequency ablation were enrolled. Then the electrophysiological characteristics of retrograde conduction through atrioventricular node were analyzed. Results One hundred and sixty-one patients（54% ）remained retrograde conduction after radiofrequency ablation. Anterograde conduction function of the patients with retrograde conduction was better than that without retrograde conduction. To the patients remai- ning ventriculoatrial conduction,the function of anterograde conduction was better than that of retrograde conduction. There were 28 patients （17%）whose orifice of coronary sinus vein were excited at first by retrograde conduction through atrioventricular node after radiofrequency ablation, the function of retrograde conduction was worse than that of the patients whose His bundle were excited at first, but there was no difference between them statisticaly. Conclusion The incidence of retrograde after radiofrequency ablation perhaps was similar to that of healthy adults. The anterograde conduction function of the patients with retrograde conduction was better than that of the patients without retrograde conduction, and was better than its own retrograde conduction function. Perhaps there were two different accesses which were excited by the retrograde conduction from atrioventricular node.