静脉注射三磷酸腺苷对旁路前向有效不应期的影响及其临床意义

Effects of Intravenous Adenosine Triphosphate on Anterograde Efective Refractory Period of Accessory Pathway and Its Clinical Significance

目的：探讨三磷酸腺苷（ＡＴＰ）静脉注射对旁路前向有效不应期（ＡＥＲＰＡＰ）的影响，为在预激综合征（ＷＰＷ）和心动过速的诊断、治疗工作中合理使用ＡＴＰ静脉注射提供指导。方法：对１８例预激综合征以特定的起搏周长起搏心房，同时静脉注射ＡＴＰ，观察心室预激波ＲＲ间期变化。结果：静脉注射ＡＴＰ后出现心室预激波ＲＲ间期延长、缩短或延长和缩短交替３种瞬间效应。结论：静脉注射ＡＴＰ能瞬时地延长或缩短ＡＥＲＰＡＰ，这对于指导ＡＴＰ静脉注射在诊断隐性预激综合征、判断旁路射频导管消融疗效以及鉴别和诊断心动过速时的临床应用具有重要意义。

Objective:To study the ettects of intravenous adenosine triphosphate (ATP) on anterograde effective refractory period of accessory pathway (AERPAP) for guiding reasonable use of intravenous ATP in the diagnosis and treatment of Wolff Parkinson White syndrome (WPW) and tachycardia. Methods:Atrial pacing at a given cycle length and intravenous ATP were simultaneously carried out to observe the change of RR intertval of preexcited QRS complex in 18 patients with WPW. Results:Intravenous ATP could instantaneously prolong(6/18 patients),shorten(6/18 patients),or prolong and shorten alternatively (6/18 patients)the RR interval of preexcited QRS complex. Conclusion:The fact that intravenous ATP could instantaneously prolong or shorten AERPAP is of important singificance for guiding the clinical use of intravenous ATP in the diagnosis of latent WPW,the evaluation of the efficacy of radiofrequency catheter ablation of accessory pathway,and the discrimination and diagosis of broad and narrow QRS complex tachycardia.