房室折返性心动过速合并房室结双径现象

Atrioventricular reentrant tachcardia with dual atrioventricular nodal pathway

目的 分析射频消融术证实的房室旁道 ( AP)合并房室结双径 ( DAVNP) ,以了解其电生理特点。方法 以食管心房调博及心内电生理检查 ,确诊室上速合并房室结双径 12例 ,并行射频消融术。结果 AP合并 DAVNP占 AP的 16 .4% ( 12 / 73) ,多为隐匿性 AP( 10 / 12 ) ,其折返途径多为 AP逆传 ( 10 / 12 ) ,房室结单一径路前传。房室结快径道不应期及心动过速时 RP′( VA )与 RR间期 ,在食道电生理与心内电生理无显著差异 ( P>0 .0 5 )。结论 AP消融后 ,对仍有 AH跳跃现象但未能诱发心动过速者 ,可作为手术终点 ,AP合并 DAVNP发生心动过速虽可存在多种折返机制 ,但以

Objective In order to investigate the electrophysiological characteristics of accessory path way(AP) with dual atrioventricular nodal pathway(DAVNP).Methods twelve patients were examined with transesophageal atrial pacing(TEAP),electrophysiological study(EPS) before and after radiofrequency ablation.Results AP with DAVNP was detected in 12 of the 73 patients(16.4%).Most APs with DAVNP were left concealed accessory pathway(83.3%,10/12).Circle length and RP′(VA) interval of PSVT and refractory period of fastpathway were not significantly different between TEAP and >005).Conclusion There is no tachycardia in patients with only A-H jump and atrial echo after ablation and the ablation procedure can be ended.Although a lot of mechanism of PSVT in AP with DAVNP,the most common is atrioventricular reentry with retroconduction of AP.