摘要
目的 探讨室上速并发心房颤动（房颤）的电生理特性及其发生机制。方法 对３８例室上速患者，根据有无房颤史分为两组，即：房颤组１８例，无房颤组２０例。分别测量两组室上速周长、心房内压、心房各部位有效不应期、心房不应期离散度、心房最大不应期与室上速周长的比值，所有对象均行射频消融术治疗室上速，并行为期半年的随访，观察两组病人房颤的发生情况。结果 房颤组与无房颤组的室上速周长分别为（３２６±９）ｍｓ，（３３１±１１）ｍｓ，Ｐ＞０．０５。在窦性心律与室上速发作时，房颤组的心房不应期离散度均较无房颤组增加，房颤组的心房最大不应期与室上速周长的比值比无房颤组明显增加（Ｐ＜０．０５）。房颤组的心房最大不应期比无房颤组增加（Ｐ＜０．０５），但却发生在心房的不同部位。结论 （１）室上速合并房颤与室上速周长无明显关系。（２）心房不应期离散度是室上速合并房颤发生和维持的一个重要机制。（３）心房最大不应期与室上速周长的比值可能是室上速诱发房颤的另一个机制。
Objective To investigate the mechanism of paroxysmal supraventricular tachycardia (PSVT) associated with paroxysmal atrial fibrillation (PAF). Methods The study population consists of 38 patients who had PSVT with (n = 18) without (n = 20) PAF. The cycle length of PSVT, atrial effective refractory period (AERP), AERP dispersion, Atrial pressure and the largest AERP/cycle length were examined during baseline and PSVT. Results (l) The cycle length of PSVT with and without PAF were (326 ± 9)ms, (331 ± 11)ms respectively (P > 0.05). (2) The atrial pressure in AF group and no AF group were (3.3 ±0.5) mm Hg, (3.4 ± 0.7) mm Hg respectively (P > 0.05 ) in baseline study. The atrial pressure in AF group had higher increase than no AF group. (3) there was greater AERP dispersion in patients with PAF than that in those without PAF during baseline study and PSVT (P < 0.05, P < 0.01 respectively). (4) The largest AERP/cycle length of PSVT with AF was greater than that of PSVT without AF. Conclusion (l) The tachycardia cycle length was similar between patients with and without PAF. (2) AERP dispersion could be one important mechanism of PSVT with AF. (3) The largest AERP/cycle length in group with AF was greater than that in group without AF, and it could be another mechanism of AF induced by PSVT. (4) The largest AERP in group with AF was greater than that in group without AF, but the largest AERP by our study was not in special site of the atrium.
出处
《中国介入心脏病学杂志》
2001年第2期89-91,共3页
Chinese Journal of Interventional Cardiology
关键词
室上速
心房颤动
机制
电生理
Supraventricular tachycardia
Atrial fibrillation
Mechanism
