【摘要】 对96例阵发性室上性心动过速患者在食道心房调搏检查时用各种不同方式的电刺激进行诱发和终止试验。共诱发室上速358次,诱发成功率97.7％。终止室上速217次,终止成功率98.6％。本文对可能影响电刺激诱发和终止成功率的各种因素进行了分析,并认为用食道心房调搏法诱发和终止折返机制的室上速是一种十分安全和有效的手段。更多还原

【Abstract】 96 consecutive cases undergone TEAP in the period from Sep. 1933 to Aug. 1988 due to SVT confirmed by ECG or medical recording were studied. 49 were male and 47 female with an average age of 39.8 years (ranged 8 to 70). SVT classification: A-V nodal reentry tachycardia in 20; orthodromic A-V reciprocating tachycardia in 27; anti-dromic A-V reciprocating tachycardia in 3, A-V reciprocating tachycardia caused by a concealed by pass tract in 24; intra-atrial reentry tachycardia in 14; automatic atrial tachycardia in 8; tachycardia caused by a mahaim fiber in 2. Different rates and kinds of programmed stimuli were used to initiate and terminate the SVT during TEAP. The output voltage used was 2.5 to 5.0 V above the pacing threshold with the pulse width of 2-10 ms. If initiation attempt failed, the protocol was repeated after atropine 1.5-2.0 nig i. v. In 87 cases of reentry tachycardia, SVT initiation was obtained in 85 (97.7%)- Among which, 17 was induced only after atropine administration. The total number of induced SVT was 358, with an average of 4.2±2.4 episodes per pt. The successful rates of SVT initiation in different types of stimulation were 72.1%, 35.2% ,62.5%, 33.3% ,54.5%, and 35.9% in extrastimulus scanning, incremental, isorhythmic, overdrive, burst, and ramping pacing, respectively. There was no difference among the various kinds of tachycardia. In the 72 cases attempt was made to terminate the tachycardia by TEAP, 68 (94.4%) were successful; combination with drug was needed in 3 cases when several attacks had been induced and termination could only be obtained by drug in the remainder one. Termination was achieved in 66/71 cases (93.0%) with burst pacing and 5/15 (33.3%) with S1S2 scanning. The successful rate of these two methods was 72.5 and 36.4%,respectively, when based on the number of attemption. The authors conclude that TEAP is a safety procedure with high successful rates to initiate and terminate the reentry SVT. The extrastimulus scanning seems best for initiation and burst pacing best for termination of tachycardia. Atropine adminstration can markedly improve the successful rate of SVT initiation.更多还原