快慢型房室结双径路心电图特征

Electrocardiography features of atypical (fast-slow type) dual atrioventricular nodal pathway

目的 观察和总结快慢型房室结双径路患者临床心电图的表现及特征。方法 8例快慢型房室结双径路的诊断均经心内电生理检查证实。根据心电图、动态心电图、食管心房调搏及心内电生理检查等资料进行心电图特点的观察和总结 ,8例患者均进行了射频消融术的治疗。结果 8例患者心电图显示隐匿性房室结双径路的特点 ,同时还有以下几个特点 :(1) 10 0 %伴有单次快慢型房室结折返性房早 ;(2 )心动过速频率 10 0～ 15 0bpm ,相对较慢 ;(3) 8例患者房室结前传曲线圆滑而无中断现象。射频消融术均获成功。结论 本文首次提出快慢型房室结双径路是一种隐匿性房室结双径路的概念 ,其具有较多特征性的心电图表现 ,注意这些特征对心电图及临床诊断能有较大的助益 。

Objective The aim of this study is to reveal the electrocardiography features in patients with atypical (fast-slow type) dual atrioventricular nodal pathway (atypical DAVNP).Methods Eight cases of atypical DAVNP were diagnosed by intracardiac electrophysiologic study, electrocardiography features were evaluated by Holter, transesophageal atrial pacing and intracardiac electrophysiological study. All the patients underwent radiofrequency catheter ablation (RFCA).Results Apart from the features of concealed dual atrioventricular nodal pathway, the electrocardiograph of these patients had following features:(1)all of patients had single fast-slow pathway reentrant premature beats;(2)the frequency of tachycardia was relative slow, at the range of 100 to 150 bpm;(3)the AV node conduction curves were smooth and had no jumpping in all 8 patients. RFCA were all successful.Conclusion Atypical dual atrioventricular nodal pathway is a concealed dual atrioventricular nodal pathway and has a few indicative electrocardiograghy features. RFCA is a safe and effective method to cure atypical DAVNP.