【摘要】 本文较详尽地叙述了对隐匿性预激的电生理检查(EPS)和术中心外膜标测方法。1例难治性房室折返性心动过速(AVRT)患者经 EPS 发现:(1)无正向预激现象;(2)经心室程序电刺激 V-A 间期恒定;(3)心室起搏或发生 AVRT 时,逆行传导心房顺序异常,最早激动点在左心房。经心内膜标测旁道定位为左侧壁。术中心外膜标测与此相符。根据标测结果成功地进行了旁道切断术。随访一年未再发作室上速。更多还原

【Abstract】 The preoperative endocardial mapping and the intraoperative epicafdial mapp-ing for one case were reported in detail.The patient with refractory paroxysmaltachyeardia had an(A-V)accessory pathway(AP)functioning as a retrogradellmb of the reentrant circuit.The electrophysiologic findings suggestive of a cente_▽aled AP included:(1)no signs of ventricular pre-excitation during sinus rhythm oratrial pacing;(2)a relatively constant VA interval during incremental ventricularpaeing;(3)the earliest activation abnormally at the lateral left atrium during ven-tricular pacing or tachyeardia.The intraoperative epicardial mapping was in favorof the existence of a bundle of Kent between the left atrium and the left ventricle.This observation confirmed the focal location of the AP determined electrophysio-logically.An operation of AP division was performed successflly.Follow-up studyat 12 months showed no recurrent tachycardia has ever been observed.更多还原