经食道心房调搏和心内电生理检查的相关性研究

Correlative Study between Through Esophagus Atrial Pacing and Intracardial Electrophysiological Study

目的 :评价经食道心房调搏 (TEAP)对室上性心动过速 (SVT)诊断价值。方法 :分析 6 1例行射频消融术 (RFCA)患者术前TEAP诱发或终止SVT的心电图情况。起搏方式为S1 S1 分级递增刺激和S1 S2 程序早搏刺激。个别患者加发S3或S4 刺激。记录诱发窗口、诱发频率、房室结不应期、诊断 ,并与RFCA时心内电生理检查 (EPS)相应指标进行相关分析。结果 :TEAP诱发SVT窗口、诱发频率、房室结不应期与心内EPS结果的相应指标均呈正相关 (P <0 0 1) ,其对SVT的诊断符合率达 95 1%。患者发生的SVT均能经TEAP终止。结论 :TEAP对SVT的确认 ,旁道的定位 ,旁道与双径路的鉴别都有一定的价值 。

Objective:To assess applicable value of through esophagus atrial pacing(TEAP)on the diagnosis of supraventricular tachycardia(SVT).Methods:Sixty-one patients with SVT were selected.The ways of pace-making were S 1S 1,gradually increasing stimulus and S 1S 2 programmable stimulus,adding S 3 or S 4 for some cases.Results of intervals of S 1S 2 evoking SVT,evoking frequency,refractory period of atrioventricular knot and diagnosis from TEAP were compared with those from electrophysiological study(EPS).Results:There was a positive correlation between TEAP and EPS in their intervals of evoking S 1S 2 SVT,evoking frequencies,refractory periods of atrioventricular knot(P<0.01).The coincidence rate for TEAP to diagnose SVT was 95.1%.TEAP could terminate SVT satisfyingly.Conclusion:TEAP is useful in ascertaining the existence of SVT,locating the accessory pathways and differentiating accessory pathways and atrioventricular nodal dual pathways.It is a necessary preparation before radio-frequency catheter ablation(RFCA).