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隐匿性房室旁道无创性诊断标准的探讨

EVALUATION OF DIAGNOSTIC CRITERIA OF CONCEALED A-V ACCESSARY PATHWAY(CAP) DURING TRANSESOPHAGEAL ATRIAL PACING (TEAP)

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【作者】 邓昭文黄自珍马虹梁耀荣

【Author】 Deng Zhaowen Huang Zizhen Ma Hong Liang Yaorong (First Affiliated Hospital)

【机构】 中山医科大学附属第一医院心内科中山医科大学附属第一医院心内科

【摘要】 报告30例隐性房室旁道所致房室折返性心动过速者,对其食道心房调搏各项诊断指标进行评价,认为这是一种有较大价值的无创性检查手段,并对PR/RP比值、PV1-PE、RPE时距等指标提出了新的见解。

【Abstract】 Thirty Cases of atrio-ventricular reciprocating tachycardia (AVRT) using a CAP diagnosed by TEAP were reported. They constituted 21.3% of the SVT seen in the same period. All the tachycardia could be initiated and terminated reproducibly by electrical stimuli. The ECO pattern showed "a retrograde P wave after QRS complex." type with the 1st PR Interval less than 0.25 sec. and an average heart rate of 189±32 bpm. The incidences of QRS alternans and functional BBB were 46.7 and 30%, respectively. Both were significantly higher than those in AVNRT (P<0.001). The functional BBB was closely related to the rapid heart rate. In 54 cases with AVRT using a left sided AP (including 28 cases of CAP and 26 cases of Type-A preexcitation), the RPE and PE-Pv, intervals were 121±19 and 67±22 nis, respectively. The authors suggest that RPE 85 ms and PE-PV1 25 ms might be used as the lower limit to identify AVRT from AVNRT, and point out that the criterion of PR/RP >1 can only be used in the esophageal lead but not in . lead V,. The authors believe that most of the AVRT using a CAP could be diagnosed by TEAP.

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