不同室房传导途径的P_(V_1)～P_E时距及临床意义的再评价

Re-evaluation of P_(V1)-P_E intelval in different types of ventriculoatrial conduction and its clinical significance

经心房标测评价33例5种室房传导的心房激动顺序。正常室房传导、房室结快径室房传导和隔侧旁道室房传导的心房激动顺序具有一致性,即P_(V1)、P_E和HRA几乎同时发生。左侧和右侧旁道室房传导具有典型特点,前者显示“左偏心”即P_(V1)～P_E时距为负值(-43.64±12.86ms);后者显示“右偏心”即P_(V1)～P_E时距为正值(40.50±12.58ms)。

With intfacardiac electrophysiologic study and atrial mapping we observed the atrial activation sequence of ventriculoatrial (V-A) conduction in 33 patients who have 5 types of V-A conduction. It was found that the V-A conduction through normal V-A pathway, fast pathway of double AVN pathways and septal atriaventricular (AV) accessary pathway had the same atrial activation sequence. The P wave in V1 (Pv1), eso-phageal lead (PE) and highright atria (HRA) occurred almost simultaneously in all these patients and consistant with concentric retrograde atrial activation. Through left and right lateral AV accessary pathways the V-A conduction bad typical features, that is 'left-sided eccentric' with left lateral AV accessary pathway (PV1-PE interval: -43.64±12.86ms) and 'right-sided eccentric' with right AV accessary pathway (Pv1-PE interval: 47.50 ± 12.58 ms ). We concluded that PV1-PE -interval was a useful indicator in diagnosis of paroxysmal supraventricular tachycardias (PSVT).