食管心房调搏对阵发性室上性心律失常的诊断意义

Value of Trans-esophageal atrial pacing to paroxysmal superventricular arrhycthmia

目的探讨食管心房调搏对阵发性室上性心律失常的诊断意义。方法应用食管导联心电图对82例各类阵发性室上性心律失常的检出率对照分析。结果房室结双径路在双极食管导联的检出率为82.57%,单极食管导联的检出率为57.3%(P<0.01);预激综合征(WPW)合并房室折返性心动过速在双极食管导联的检出率为11.46%,单极食管导联的检出率为10.98%(P<0.05)。室性心动过速伴房室分离在双极食管导联的检出率为2.75%,单极食管导联心电图的检出率为1.22%(P<0.05);室性心动过速与心房扑动并存在双极食管导联的检出率为2.29%,单极食管导联心电图的检出率为1.22%(P<0.05);室性心动过速伴1:1室房逆传在双极食管导联的检出率为1.83%,单极食管导联心电图的检出率为1.22%(P<0.05)。结论双极食管导联对阵发性室上性心律失常的检出率比单极食管导联的检出率高,安全、可靠、实用、能定位、对射频消融术前病例的筛选具有重要作用。

Objective To explore the diagnostic value of trans-esophageal atrial pacing to paroxysmal superventricular arrhythmia.Methods Analysis the detection rate of a bipolar esophageal leads electrocardiography among 82 patients with paroxysmal superventricular arrhythmia.Results The detection rates had differences between a bipolar esophageal lead electrocardiography and unipolar esophageal lead electrocardiography in atrioventricular node dual pathways （ 82.57% vs 57.32%,P〈0.01）,accelerated conduction syndrome with atrioalventricular reentrant tachycardia （11,46% vs 10.98%,P〈0.05）,ventricular tachycardia with atrio-ventricular separate（2.75% vs 1.22%,P〈0.05）,ventricular tachycardia with atrial flutter （2.29% vs 1.22%,P0.05）,and ventricular tachycardia with 1：1 ventricular-atrial against pass （1.83% vs 1.22%,P〈0.05）.Conclusion Comparing with unipolar esophageal lead electrocandiography,bipolar esophageal lead electrocandiography has higher detection rate to paroxysmal superventricular arrhythmia,and it is a safe、dependable and useful way.