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目的 研究心动过速时心室起搏拖带对房室结折返性心动过速 (AVNRT )和间隔旁路参与的顺向型房室折返性心动过速 (间隔旁路ORT)的鉴别意义。方法 30例AVNRT和 2 5例间隔旁路ORT病人在心动过速发生后 ,采用较心动过速的周长 (TCL)短 10～ 4 0ms的周长行右心室起搏拖带心动过速。测量右心室起搏之前的心室 心房 (VA)间期和TCL。停止起搏后 ,测量最后一次刺激信号至最后起搏拖带的心房激动 (SA)间期 ,以及起搏后间期 (PPI)。结果 所有 30例AVNRT病人的SA -VA间期 >85ms、PPI-TCL >115ms,而 2 5例ORT病人的SA -VA间期 <85ms、PPI-TCL <115ms。结论 PPI TCL和SA VA间期是鉴别AVNRT和间隔旁路ORT的非常可靠的指标 ,具有较高的特异性。
Objective To investigate the differential significance of ventricular pacing and towing in atrioventricular nodal reentrant tachycardia (interval bypass ORT) with atrioventricular nodal reentrant tachycardia (AVNRT) and interval bypass. Methods Thirty patients with AVNRT and 25 patients with bypass ORT underwent right ventricular pacing and tachycardia after a circumferential tachycardia (TCL) shorter than 10 ~ 4 ms after tachycardia. Ventricular atrial (VA) interval and TCL were measured before right ventricular pacing. After stopping the pacing, the atrial activation (SA) interval from the last stimulation signal to the last pacing and the pacing interval (PPI) were measured. Results All 30 AVNRT patients had an SA-VA interval of> 85 ms and PPI-TCL> 115 ms, while 25 of 25 ORT patients had a SA-VA interval of <85 ms and a PPI-TCL of <115 ms. Conclusions PPI TCL and SA VA interval are very reliable indexes to distinguish AVNRT and interval bypass ORT and have high specificity.