RR间期不齐的室上性心动过速六例发生机制分析

Analysis of the Mechanisms of Supraventricular Tachycardia with Irregular RR Intervals in Six Patients

目的探讨RR间期不齐的室上性心动过速的发生机制。方法分析来我院就诊的6例RR间期不齐的室上性心动过速患者的心电图及其发生机制。结果 3例确诊为房室结折返性心动过速,3例确诊为房室折返性心动过速。发生RR间期不齐室上性心动过速的原因分别为:患者1和患者2受折返环路组织不应期的影响;患者3和患者4是由于折返环路发生改变;患者5是由于窦性心律干扰了折返激动;患者6是由于折返环路以下的双侧束支发生了传导阻滞。结论心动过速时组织不应期的影响,折返环路的改变,折返环路内、外心律的变化,折返环路以下部位传导的异常等均可导致RR不齐的发生。

Objective To explore the mechanisms of supraventficular taehycardia （SVT） with irregular RR intervals. Methods The clinical data of 6 SVT cases with irregular RR intervals and the different meehanisms were analyzed. Results A- mong 6 ease, 3 were diagnosed as atrioventricular nodal reentrant taehyeardia （AVNRT） , and 3 were diagnosed as atrioventricu- lar reentrant tachycardia （AVRT）. The mechanisms were as follows ： For Case 1 and Case 2, it was associated with the change of refractory period of the reentrant loop ; For Case 3 and Case 4, it was due to the ehange of the reentrant loop ; for Case 5, it was related to the interruption of the sinus rhythm; and for Case 6, it was due to the conduction block of bilateral bundle branch. Condusion The irregular RR intervals might be related to the change of refractory period of the reentrant loop, the change of the reentrant loop, the change of heart rate in or out of the reentrant loop ; Or abnormal conduction below the reentrant loop.