食管及改良V_1导联心电图对PSVT进一步定性的意义

The Signification of the oesophagus and vary V_1 ECG to determine the nature of PSVT

目的:探讨经食管导联心电图(ECGe)及改良V_1导联心电图(ECGvv_1)对常规心电图(ECG)诊断为阵发性室上性心动过速(PSVT)病人的发病机理进一步定性的意义。方法:(1)将食管电极导管经97例PSVT受检者鼻腔送至左心房水平记录各极的ECGe;(2)将V_1导联电极沿胸骨右缘从第二肋间向第五肋间依次作记录寻找到较清晰的P波。结果:对照记录的ECGe和ECGvv_1结果,诊断旁路合并房室折返性心动过速(AVRT)66例,房室结双径路合并房室结折返性心动过速(DAVNP+AVN-RT)31例。所有结果均经心内电生理检查(EPS)及射频电消融术(RFCA)所证实。结论:ECGe及ECGvv_1是非创伤性检查能认识该类病人的电生理特性的手段,对常规ECG的PSVT诊断的发病机制有完善和补充作用。该法所需设备简单,操作方便,无并发症,结果准确可靠,值得广泛推广。

objective:To discuss the signification of the oesophagus ECG(ECGe)and vary V, ECG(ECGvv1 )to determine the nature and classify of paroxysmal supraventricular tachycardia( PSVT) diagnosed by nomal 12 leads ECG. Method :97 cases with PSVT diagnosed by standard ECG were recorded by ECGe and ECGvv1 during onset. Result :66 cases of them were diagnosis as the atrioventricular reentrant tachycardia with 61 cases of left accessory pathways, 3 cases of the right accessory pathways and 2 cases of septal accessory pathway ;31 cases as the dual atrioventricular node pathway with atrioventricular node reentrant tachycardia. The results of all patients were proved by in-terventional electrophysiological results followed up. Conclusion: ECGe and ECGvv1 are the methods that can recognize the natures of invasive electrophysiology with noninvasive examination, can complete and supply the diagnosis of mechanism about PSVT. The method with simple equipments, handle facility, no complication, exact and credible results is worth to popularize.