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目的 探讨小儿不同类型心动过速的构成比、相应的临床特点和体表心电图 (ECG)特征。方法 对 1985年 3月～ 1999年 4月经我院心内电生理检查确诊为快速型心律失常的 2 40例患儿进行分析 ,其中 2 2 9例经射频消蚀证实。结果 (1) 2 40例患儿中 ,2 15例为室上性心动过速 (SVT) ;2 5例为特发性室性心动过速 (IVT)。 2 15例SVT中 ,16 4例为旁道参与的房室折返性心动过速 (AVRT) ,其中显性旁道 10 3例 ,隐匿性旁道 5 9例 ,持续性交界区反复性心动过速 (PJRT) 2例 ;房室结折返性心动过速 (AVNRT) 39例 ,房性心动过速 8例 ,心房扑动 4例。 5 9例隐匿性房室旁道中 ,7例心动过速时体表ECG逆传P波与QRS波重叠或紧随其后 ,与AVNRT无法鉴别。 2 5例IVT心室速率 15 0～ 2 40(198± 2 6 )次 min ,QRS波时限 0 .0 9～ 0 .12 (0 .11± 0 .0 1)s,2 0例有室房分离。 19例室性心动过速 (VT)起源于左心室 ,6例起源于右心室流出道。 (2 ) 2 40例中 ,9例合并器质性心脏病 ,分别为Ebstein畸形、室间隔缺损、动脉导管未闭、心内膜弹力纤维增生症和心肌炎。 9例因心动过速持续发作而并发心动过速性心肌病 ,其中 4例经射频消蚀成功治疗后心脏各项指标恢复正常。结论 (1)AVRT和AVNRT是小儿室上性心动过速中最常见的两种类型 ;(2
Objective To investigate the constituent ratio of different types of tachycardia in children, the corresponding clinical features and the characteristics of body surface electrocardiogram (ECG). Methods From March 1985 to April 1999, 240 cases of tachyarrhythmia diagnosed by electrophysiological examination in our hospital were analyzed, of which 299 cases were confirmed by radiofrequency ablation. Results (1) Among 240 children, 215 were supraventricular tachycardia (SVT) and 25 were idiopathic ventricular tachycardia (IVT). Among the 15 SVT cases, 16 4 were AVRT, with 103 cases of overt bypass and 59 cases of occult bypass, and persistent tachycardia (PJRT) in 2 cases; atrioventricular nodal reentrant tachycardia (AVNRT) in 39 cases, atrial tachycardia in 8 cases, atrial flutter in 4 cases. Among 59 cases of occult atrioventricular bypass, seven cases of tachycardia showed that the ECG reversed P wave and QRS wave overlap or immediately followed by AVNRT. Twenty-five patients with IVT had a ventricular rate of 15 0 to 240 (198 ± 2 6) min, QRS wave duration 0. 0 9 to 0. 12 (0.11 ± 0. 01) s, and 20 had ventricular septum . 19 cases of ventricular tachycardia (VT) originated in the left ventricle, 6 cases originated in the right ventricular outflow tract. (2) Among 240 cases, 9 cases had organic heart disease, including Ebstein’s malformation, ventricular septal defect, patent ductus arteriosus, endocardial fibroelastosis and myocarditis. 9 cases of tachycardia sustained attack and concurrent tachycardia cardiomyopathy, including 4 cases of successful treatment by radio frequency eradication of the heart indicators returned to normal. Conclusions (1) AVRT and AVNRT are the two most common types in supraventricular tachycardia (2