食管心房调搏终止妊娠期阵发性室上性心动过速的临床研究

Transesophageal atrial pacing in the treatment of paroxysmal supraventricular tachycardia in pregnancy

目的探讨经食管心房调搏超速抑制终止妊娠期阵发性室上性心动过速(PSVT)的临床疗效及安全性。方法抽取2004年5月至2018年12月于郑州大学第二附属医院治疗的31例妊娠期PSVT患者为研究对象,所有患者均采用S1S1定数,起始电压20 V,以快于PSVT频率30~50次/min的刺激进行2~5次,如若不能终止,则适当加快频率、增加刺激个数或增加输出电压,重复S1S1刺激,个别未转复患者使用RS2刺激终止PSVT。结果所有患者PSVT经食管心房调搏超速抑制治疗后均得以终止,其中28例经S1S1刺激后PSVT得以终止,3例经RS2刺激得以终止,临床转复率为100%,复律过程中患者自身未出现不良反应,胎儿心律也未受到影响。结论经食管心房调搏超速抑制终止妊娠期PSVT疗效肯定、安全、快捷,可重复进行。

Objective To study the clinical efficacy and safety of transesophageal atrial pacing in the suppression and termination of paroxysmal supraventricular tachycardia(PSVT)in pregnancy.Methods Thirty-one pregnant women with PSVT treated in the Second Affiliated Hospital of Zhengzhou University from May 2004 to December 2018 were selected as research objects.All patients were stimulated by S1S1 for 2-5 times at a frequency of 30-50 times/minute faster than PSVT,and the initial voltage was 20 V.If the PSVT could not be stopped,the stimulation frequency,number of stimulation and output voltage could be increased properly for repeated S1S1 stimulation.If above methods could not work,RS2 stimulation should be used to terminate PSVT.Results PSVT in all patients were terminated by transesophageal atrial pacing.Of them,28 cases were terminated after the stimulation of S1S1,and 3 cases were terminated after the stimulation of RS2,additionally.The clinical recovery rate was 100%.There was no adverse reaction in the treatment,and the heart rates of fetus were not affected.Conclusions Transesophageal atrial tachycardia is a safe,rapid and repeatable method for termination of PSVT in pregnancy.