食管心房调搏检查对窄QRS波群心动过速的诊断意义

Value of transesophageal atrial pacing used for narrow QRS-wave tachycardia

目的探讨食管电生理检查对窄QRS波群心动过速诊断的临床意义。方法比较98例窄QRS波群心动过速食管和心内电生理检查的结果。结果98例窄QRS波群心动过速97例分型诊断一致:房室折返性心动过速52例,房室结内折返性心动过速32例,心房内折返性心动过速和心房扑动各5例,房性自律性心动过速、窦房折返性心动过速和室性心动过速各1例。6例房性心动过速与54例房室折返性心动过速起源两种检查结果完全一致。结论食管心房调搏对窄QRS波群心动过速的分型诊断和初步定位诊断具有很高的准确性,故可作为必要检查,有助筛选射频导管消融病例。

Objective To discuss diagnostic clinic value of transesophageal eletrophysiological examination applied in narrow QRS-wave tachycardia. Methods 98 patients were examed by means of both cardiacical examination and transesophageal atrial pacing. Results Among 98 patients, 97 patients got same results from two means, of which there were 52 patients with atrialventricular reentrant tachycardia, 32 with atrialventricular node reentrant tachycardia, 5 with intra-atrial tachycardia, 1 with automatic atrial tachycardia, 1 with sinusatrial reentrant tachycardia, 5 with atrial flutter, 1 with ventricular tachycardia.6 cases with atrial tachycardia and 54 with atriaventricular reentrant tachycardia got the same results of locating exciting spot by two means. Conclusion Transesophageal atrial pacing is an accurate method to diagnose narrow QRS-wave tachycardia and locate exciting spot, thus, it may be necessary to chose suitable cases for radiofrequency ablation theropy.