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目的探讨食管心房调搏术(TEAP)在婴幼儿室上性心动过速(SVT)诊断和治疗中的应用价值。方法选取43例年龄<2岁的SVT婴幼儿。其中男23例,女20例;年龄(7.59±9.80)个月。采用TEAP检查,随后根据记录食管心电图进行分型诊断,明确为折返性心动过速、房性心动过速、房性扑动后立即进行超速抑制终止心动过速。并对其资料进行回顾性分析。结果 43例SVT婴幼儿经食管电生理检查,心室率为(233.31±46.79)次.min-1。其中29例次SVT中诊断为折返型SVT23例次,房性动过速3例次,窦性心动过速并Ⅰ度房室传导阻滞(Ⅰ-AVB)2例次,窦性心动过速1例次,房性扑动14例次。宽QRS心动过速2例,1例为Ⅰ-AVB并室内传导阻滞,另1例经随访确诊为交界性心动过速并室内传导阻滞。经TEAP成功转复率为83%(34/41例)。结论婴幼儿SVT往往伴较快心室率,如不及时救治极易产生不可逆的损害。TEAP的应用有助于婴幼儿SVT的诊断分型,而且其安全快速转复窦性心律的优点在婴幼儿心动过速的抢救中起重要作用。
Objective To investigate the value of esophageal atrial pacing (TEAP) in the diagnosis and treatment of supraventricular tachycardia (SVT) in infants. Methods Forty-three SVT infants younger than 2 years old were selected. Including 23 males and 20 females; age (7.59 ± 9.80) months. The use of TEAP examination, followed by classification of esophageal electrocardiogram record diagnosis, specifically reentrant tachycardia, atrial tachycardia, atrial flutter immediately after the termination of tachycardia speeding. The data were retrospectively analyzed. Results 43 cases of SVT infants underwent transesophageal electrophysiological examination, ventricular rate was (233.31 ± 46.79) times min-1. Of the 29 cases, SVT was diagnosed as 23 cases of reentrant SVT, 3 cases of atrial tachycardia, 2 cases of sinus tachycardia and Ⅰ degree atrioventricular block (Ⅰ-AVB), sinus tachycardia 1 case, atrial flutter 14 cases times. Wide QRS tachycardia in 2 cases, 1 case of Ⅰ-AVB and conduction block, and the other was followed up by the diagnosis of borderline tachycardia and conduction block. The success rate of TEAP was 83% (34/41 cases). Conclusion Infants with SVT often have faster ventricular rate, if not prompt treatment can easily produce irreversible damage. The application of TEAP is helpful for the diagnosis of SVT in infants and young children, and the safe and rapid reversion of sinus rhythm has an important role in the rescue of tachycardia in infants.