经食管心房调搏中两种不同刺激方法在终止阵发性室上速中的临床应用效果对比研究

A comparative study of clinical effects of two different stimulation methods in transesophageal atrial pacing for termination of paroxysmal supraventricular tachycardia

目的探讨经食管心房调搏中两种不同刺激方法[短阵猝发(Burst)刺激法和改良非程序(S1S1)超速刺激法]在终止阵发性室上性心动过速(阵发性室上速)中的临床应用效果。方法选取2014年1月～2015年12月收治的68例阵发性室上速采用Burst刺激法诊疗的患者作为对照组,另选取2016年1月～2017年12月收治的87例阵发性室上速采用改良S1S1超速刺激法诊疗的患者作为研究组,比较两组患者转复成功率以及调搏过程中各种心律失常现象发生情况。结果研究组患者转复成功率为98.9%,高于对照组患者的86.8%,差异具有统计学意义(χ~2=9.2374, P<0.05)。研究组患者房颤/房扑、终止后再诱发心动过速、长RR间歇、单发室早和成对室早发生率分别为0、0、1.1%、5.7%、3.4%,均低于对照组患者的8.8%、8.8%、11.8%、16.2%、17.6%,差异具有统计学意义(χ~2=7.986、7.986、7.864、4.485、8.803, P<0.05)。结论阵发性室上速患者采用改良S1S1超速刺激法治疗,相比Burst刺激法治疗,其转复成功率更高,房颤/房扑、终止后再诱发心动过速、长RR间歇、单发室早和成对室早发生率更低,值得在临床推广应用。

Objective To discuss the clinical effect of two different stimulation methods [short tone burst(Burst) stimulation and modified non-programmed(S1S1) hyperstimulation] in transesophageal atrial pacing for termination of paroxysmal supraventricular tachycardia. Methods There were 68 patients with paroxysmal supraventricular tachycardia diagnosed and treated by Burst stimulation in January 2014 ~ December 2015 wereselected as the control group, and 87 patients with paroxysmal supraventricular tachycardia diagnosed and treated by modified S1 S1 hyperstimulation in January 2016 ~ December 2017 were selected as the research group. The conversion success rate and the occurrence of various arrhythmias during pacing were compared between the two groups. Results The research group had higher conversion success rate as 98.9% than 86.8% in the control group, and the difference was statistically significant(χ~2=9.2374, P<0.05). The research group had lower incidence of atrial fibrillation/atrial flutter, re-induced tachycardia after termination, long RR intervals, single ventricular premature and paired ventricular premature respectively as 0, 0, 1.1%, 5.7% and 3.4% than 8.8%, 8.8%, 11.8%, 16.2% and 17.6% in the control group, and their difference was statistically significant(χ~2=7.986, 7.986, 7.864, 4.485, 8.803, P<0.05). Conclusion Compared with Burst stimulation, modified S1 S1 hyperstimulation has a higher conversion success rate in the treatment of paroxysmal supraventricular tachycardia. It can induce incidene of atrial fibrillation/atrial flutter, re-induced tachycardia after termination, long RR intervals, single ventricular premature and paired ventricular premature. It is worthy of clinical promotion and application.