心房超速递增刺激中止心房扑动

Use of overdrive atrial Incremental stimulation in termination of atrial flutter

为探讨心房刺激中止心房扑动的方法及其效果,采用高于心房扑动频率心房超速起搏,S_1S_1递增刺激治疗心房扑动31例,其中心内右心房刺激11例,食管心房刺激20例.结果10例(32.3%)转为窦性心律,11 例(35.5%)诱发心房颤动后数s～3min内转为窦性心律,5例(16.1%)转为心房颤动后分别在20min、6h、1天、20天、1月后转为窦性心律,无效5例(16.1%),心内刺激与食管刺激效果差异无显著意义(P>0.05);转为心房颤动的16例,心室率由心房扑动时的132.6±28.8次/min变为心房颤动时的90.0±24.7次/min,心室率明显减慢(P<0.01),临床症状明显减轻,且无室性心律失常等并发症发生.提示心房超速递增刺激方法中止心房扑动有效、安全、简便,值得临床推广.

To investigate methods and results of atrial stimulation used to terminate atrial flutter, we used S1S1 incremental stimulation whose overdrive was faster than atrial rate to terminate atrial flutter. There were total 31 cases, 11 patients were treated by atrial stimulation via right atrium, 20 patients via esophagus. Results showed 10 cases (32.3%) were reversed to sinus rhythm within 3 minutes; 5 eases (16. 1%) were ineffective; there were no obvious difference between method with right atrium or without esophagus (P> 0.05) .In 16 cases which were reversed to atrial fibrillation, their ventricular rate decreased obviously from 132.6?28.8 bpm(atrial flutter)to 90.0?24.7(atrial fibrillation) (P < 0.01), their symptoms alleviated greatly. There were no complications such as ventricular arrhythm, ecl. Result suggested that method of overdrive incremental stimulation to terminate atrial flutter was effective, safe, easy to do and could be used in clinic widely.