食管心房调搏诊断右侧隐性旁路所致房室折返性心动过速

Diagnosis of a Case of Right-Sided Recessive Accessory Pathway and Atrioventricular Reciprocating Tachycardia by Transesophageal Atrial Pacing (TEAP)

右侧隐性房室旁路是一种罕见的临床情况,报道1例用食管心房调搏及作者首创的V_1及单极食管导联同步描记法诊断,后经心内电生理检查、心外膜标测及手术证实的右侧隐性旁路所致房室折返性心动过速.就作者所知,这是文献上首例用无创性方法诊断的右侧隐性房室旁路。

The right-sided recessive accessory pathway (CAP) is rare clinically, the diagrnosis of which usually depends on the intracardiac catheter method and electrophysiological study. In 1985, the authors intiated a noninvasive method for studying the atrial activation sequence by using synchronous recordings of V_1 and esophageal leads which made possible the localization of CAP during AVRT. This presentation reports a case of a 24-year old male with a right-sided CAP and refractory recurrent AVRT diagnosed by TEAP in combination with synchronous multichannel recording techniques, which was confirmed by intracardiac electrophysiological study and epi- cardial mapping as well as subsequent surgery. To the best of our knowledge, this might propably be the first case of right-sided CAP diagnosed by a noninvasive method in the medical literature,