体外无创性起搏终止快速心律失常的临床观察

Clinical Observation of Noninvasive External Cardiac Programmed Stimulation for Termination of Tachyarrhythmias

为评价体外无创性程控起搏终止快速心律失常的疗效、安全性和患者的耐受性，对３１例房室折返性心动过速（ＡＶＲＴ）、１６例房室结折返性心动过速（ＡＶＮＲＴ）、１例房性心动过速、３例心房扑动和２例室性心动过速患者进行体外程控起搏终止心动过速的治疗。４７例ＡＶＲＴ和ＡＶＮＲＴ患者的６７次发作中６１次（９１．０％）被成功终止，其中ＡＶＲＴ的有效率（９３．５％）高于ＡＶＮＲＴ（８５．７％），Ｐ＜０．０５。１例室性心动过速被终止。所有房性心律失常都未被终止。同一输出电流强度下，递减刺激法终止ＡＶＲＴ和ＡＶＮＲＴ的总成功率（８６．４％）高于期前刺激法（４１．０％）和短阵超速抑制法（５５．０％），Ｐ均＜０．０５。部分患者有胸部皮肤疼痛感，但大多数患者能够耐受，且无心肌损伤。因此。

To evaluate the efficacy,safety and tolerance of noninvasive external cardiac programmed stimulation for termination of tachyarrhythmias,the extrastimuli,burst overdrive and autodecremental pacing was used in 47 patients of atrioventricular reentrant taychcardia(AVRT) and atrioventricular nodal reentrant tachycardia(AVNRT),1 patient of atrial tachycardia (AT),3 patients of atrial flutter (AF) and 2 patients of ventricular tachycardia (VT).The rate of successfully terminating AVRT and AVNRT was 91.0%.The effective of autodecremental pacing(86.4%) was superior to burst overdrive (55.0%) and extrastimuli pacing (41.0%) at the same output current,P<0.05.The sideeffect was thumping sensation in chest,welltolerance pain,and there was no muscular or mycardial injury.Noninvasive external cardiac programmed pacing is simple,rapid and effective methed for terminating AVRT and AVNRT.