沿海居民隐匿性预激综合征旁路定位173例临床分析

Clinical analysis of 173 cases of concealed pre-excitation syndrome for the positioning of accessory bypaths in coastal inhabitants

目的 探讨隐匿性预激综合征患者房室折返性心动过速发作时逆传P波的形态、RP及RPV1-RPE间期在房室旁路定位中的价值.方法 173例经心内电生理确诊并成功消融的隐匿性预激综合征患者,观察房室折返性心动过速发作时逆传P波的形态、RP间期及RPV1-RPE间期.结果 左侧旁路中Ⅰ、avL呈（-）75例（63.0%）,右侧旁路中Ⅰ、avL呈（＋）46例（71.9%）;间隔旁路中Ⅱ、Ⅲ、avF呈（-）44例（100.0%）;右后间隔RPE间期最短[（92.6±13.1） ms],RPV1-RPE间期在右后间隔最短[（16.6±12.3） ms].结论 根据逆传P波的形态、RP及RPV1-RPE间期可以对隐匿性预激综合征患者房室旁路较精确定位.

Objective To investigate the value of retrograde P wave morphology, RP interval and RPV1-RPE interval in the positioning of atrioventricular bypath at the onset of atrioventricular reentrant tachycardia with concealed pre-excitation syndrome.Methods One hundred and seventy-three cases with concealed pre-excitation syndrome underwent electrophysiology examination and radiofrequency ablation. Retrograde P wave morphology, RP interval and RPV1-RPE interval were monitored at the onset of atrioventricular reentrant tachycardia with concealed pre-excitation syndrome. Results The inversion of retrograde P wave in lead Ⅰand avL displayed in 75 cases （63.0%）in the left bypath. The erection of retrograde P wave in lead Ⅰand avL displayed in 46 cases （71.9%） in the right bypath. The inversion of retrograde P wave in lead Ⅱ, Ⅲ and avF displayed in 44 cases （100.0%） in LPS and RPS. The shortest interval of RPE was in RPS （92.6±13.1 ms） （P〈0.01）. The shortest interval of RPV1-RPE was in RPS （16.6±12.3 ms） （P〈0.01）.Conclusions On the basis of retrograde P wave morphology, RP interval and RPV1-RPE interval, more accurate positioning of atrioventricular bypath could be made in patients with concealed pre-excitation syndrome.