食管心房调搏对心源性晕厥病因的诊断价值

Analysis of atrial pacing through esophagus on causes of cardiogenic syncope

目的 :探讨食管心房调搏 (TEAP)对心源性晕厥病因的诊断价值。方法 :对 70例无明确心脏病史 ,但伴有心悸的晕厥患者 ,给予TEAP检查 ,其中 2 9例窦房结 (SN)和 (或 )房室结 (AVN)功能低下者 ,又给予阿托品阻滞试验。结果 :SN与AVN功能低下检出率分别为 2 8.5 7% (2 0 /70 )与 34 .2 9% (2 4/70 ) ,其中迷走神经张力增高性SN与AVN功能低下检出率分别为 17.2 4% (5 /2 9)与 72 .41% (2 1/2 9) ,诱发室上性心动过速 (SVT) 5 .71% (4/70 ) ,诱发快速房颤 (Af)与房扑 (AF)共 7.14% (5 /70 )。结论 :TEAP结合阿托品阻滞试验对缓慢性心律失常及快速室上性心律失常引起心源性晕厥的病因诊断有一定临床价值。

Aim: To explore the diagnostic role of atrial pacing through esophagus (TEAP) on cardiogenic syncope. Methods: A total of 70 cases of syncope with palpitation were tested with TEAP. Twenty nine out of 70 patients with sinus node (SN) dysfunction or/and atrioventricular nodal (AVN) dysfunction underwent atropine block test. Results: The detection rates of SN dysfunction and AVN dysfunction were 28.57% (20/70) and 34.29%(24/70),respectirely,and those of vagotonia SN dysfunction and vagotonia AVN dysfunction were 17.24%(5/29) and 72.41%(21/29). The detection rate of supraventricular tachycardia (SVT)was 5.71%(4/70), and that of atrial fibrillation (Af) and atrial flutter (AF) with rapid ventricular rate was 7.14%(5/70). Conclusion: TEAP combined with atropine block test is of clinical value in diagnosng the causes of Cordiogenic syncope