快速心房起搏时SV间期与SS间期的比值在房室结折返性心动过速慢径消融中的应用

Appliance of SV/SS Ratio During Rapid Atrial Pacing for the Slow Pathway Ablation on Slow-Fast Atrioventricular Nodal Reentrant Tachycardia.

评价快速心房起搏时最快 1∶1房室传导的SV间期 (SV间期 )与 1∶1房室传导的最短S1S1间期 (SS间期 )的比值 (SV/SS)在房室结折返性心动过速 (AVNRT)慢径消融中的应用 ,将AVNRT分为房室结功能曲线连续组 (Ⅰ组 ,10例 )及房室结功能曲线不连续组 (Ⅱ组 ,17例 )测量心房分级递增刺激时的SS间期与SV间期及SV/SS ,并进行消融前、后和组间比较。结果显示 ,两组消融后SV间期较消融前明显缩短 (Ⅰ组 :2 2 1.0± 2 2 .3vs 35 7.0± 43.7ms;Ⅱ组 :2 0 2 .1± 30 .6vs 379.4± 44 .2ms,P均 <0 .0 5 ) ;消融前后SS间期无明显变化 (Ⅰ组 :310 .0± 40 .6vs 30 8.0± 36 .8ms;Ⅱ组 :332 .9± 48.1vs 336 .5± 6 2 .3ms) ;两组中所有患者消融前SV/SS比值均 >1,而消融后SV/SS比值均 <1。结论 :SV/SS可作为慢径消融成功终点的辅助观察指标之一 ,尤其对于房室结传导曲线呈连续性者 ,使用此方法可简便地观察消融终点 ,增加消融的目的性。

The purpose of the study is to evaluate SV/SS ratio during rapid atrial pacing for the slow pathway ablation on slow fast atrioventricular nodal reentrant tachycardia(AVNRT).The patients were devided into two groups.Group Ⅰ included ten patients with AVNRT and continuous atrioventricular nodal function curves,group Ⅱ included seventeen patients with AVNRT and discontinuous AV nodal function curves.The SV and SS intervals were measured during rapid atrial pacing at the maximum rate with consistent 1∶1 atrioventricular conduction.SV intervals of all patients shortened after slow pathway ablation(group Ⅰ:221.0±22.3 vs 357.0±43.7 ms,group Ⅱ:202.1±30.6 vs 379.4±44.2 ms, P <0.05 respectively).All the SV/SS ratio exceeded 1.0 before ablation and <1 after ablation no matter in which group.Conclusion:The SV/SS ratio can be determined as one of the assistant end points of slow pathway ablation on AVNRT.This finding may be particularly useful in patients with inducible AV nodal reentry without dual AV nodal physiology on atrial extrastimulus testing.