房室折返性心动过速旁道传导性质对心动过速发作特征的影响

AV reentrant tachycardia due to concealed accessory pathway to the effective of the tachycardia features

目的探讨房室折返性心动过速(AVRT)旁道(AP)传导性质对心动过速发作特征的影响。方法113例AVRT行射频导管消融术(RFCA)前行电生理刺激或静脉滴注异丙肾上腺素后行电生理检查。结果 113例中显性AP15例,98例均为隐匿性AP,发现AP逆传不应期越短,AVRT越易诱发,心动过速的频率也越快,持续时间越长久;而不应期越长.心动过速越难诱发.持续时间短暂;诱发AVRT时,诱发窗口的AP逆传周期与随后发作的心动过速周期间存在着线性关系;房室结的正向传导不应期与AP的逆传不应期差距大时,AVRT易授诱发反之不易诱发。结论 对少数AVRT有心动过速症状而无。EKG发作证据或有EKG发作证据但RFCA前电生理检查不能诱发心动过速的患者须持续滴注异丙肾上腺素才能排除AP的存在。

Objective To evaluate the AV reentrant tachycardia (AVRT) due to concealed accessory pathway to the effective of the tachycardia features.Methods 113 cases with AVRT were performed radiofrequenry catheter ablation (RFCA) before electrophysiologic stimulation test or after injection isoproperenol.Results Positive cases (n= 15) , negative cases (n=98) infers that AP retrograde conduction' s refactory period more shorten AVRT more easy to induct. The duration more long if the frequency of AVRT more quick AVRT are difficult to induct if the refaitc-ry period too long, The duration are shortend. when stimulating AVRT the AP retrograde conduction cycle correlated line with the following AVRT's cycle. If atrioventricular nodal' s positive conductive refactory period between AP' s retrograde conductive' s refactory period difference increased, AVRT are easy to induct, vice versa.Conclusions To few AVRT patients have clinical symptom but no EKG' s evidence or have EKG' s evidence but electropysiologic test could' t bring out AVRT, but manifested by isoproperenol can exclude AP.