【摘要】 目的:探讨房室折返性心动过速(AVRT)的重整特点及对经典重整概念的质疑。方法:选择41例行射频消融治疗的顺向型AVRT患者,心动过速发作时,在心脏的不同部位进行S2刺激扫描,观察心动过速对S2刺激的重整反应。结果:28例(其中左侧房室旁路19/32例,右侧房室旁路9/9例)经高位右房AS2刺激可以使心动过速重整,39例(其中左侧房室旁路30/32例,右侧房室旁路9/9例)经右心室VS2刺激可以使心动过速重整。其中8例左侧旁路患者从左心房、左心室刺激均能发生重整。重整时,偶联间期与回归周期之和(即代偿间歇)与心动过速周长(CL)的关系有3种不同的表现。结论:重整与刺激部位到折返环的距离密切相关;代偿间歇不仅可以小于CL的2倍,也可以大于或等于CL的2倍。更多还原

【Abstract】 Objective:To investigate the characteristics of resetting of atrioventricular reentrant tachycardia (AVRT) and argue classical concept of resetting. Method:S2 stimulus scanning was performed during tachycardia at different sites of the heart and resetting response was observed in 41 cases of AVRT for radiofrequency catheter ablation. Result:Tachycardia was resetted in 28 cases (19/32 using left accessory pathway, 9/9 using right accessory) when premature stimuli were delivered from high right atrium, and in 39 cases (30/32 using left accessory pathway, 9/9 using right accessory pathway) when premature stimuli were delivered from right ventricle. In all the 8 cases using left accessory pathway, tachycardia could be resetted when pacing from left atrium or left ventricle. There were 3 patterns of resetting as to the relationship of the sum of coupling interval and return cycle with 2 times of cycle length. Conclusion:Resetting is closely associated with the distance between the pacing site and reentrant circuit. The sum of coupling interval and returning cycle may not only be less than 2 times cycle length, but be greater than or equal to 2 times cycle length as well.更多还原