摘要
目的 评价经食道心房调搏（ Ｔ Ｅ Ａ Ｐ） 中刺激方式及阿托品的应用对诱发阵发性室上性心动过速（ Ｐ Ｓ Ｖ Ｔ） 的影响，以探讨提高诱发的成功率。方法 对１８０ 例临床确有或疑有 Ｐ Ｓ Ｖ Ｔ 者行 Ｔ Ｅ Ａ Ｐ，于基础状态采用 Ｓ１ Ｓ１（ Ｓ１） 法、 Ｓ１ Ｓ２（ Ｓ２） 法未能诱发者行 Ｓ１ Ｓ２ Ｓ３（ Ｓ３） 法刺激，上３ 法均不能诱发者静注阿托品（０ ．０２ ｍｇ／ｋｇ） 后重复上述方法。结果 基础状态共诱发 Ｐ Ｓ Ｖ Ｔ１２６ 例（７０ ．０ ％ ） ，其中采用 Ｓ１ 诱发４０ 例（２２ ．２ ％ ） ，加用 Ｓ２（ Ｓ１ ＋ Ｓ２） 共诱发１０４ 例（５７ ．８ ％ ） ，不能诱发者加用 Ｓ３ 又诱发成功２２ 例，则 Ｓ１ ＋ Ｓ２ ＋ Ｓ３ 共诱发１２６ 例（７０ ．０ ％ ） ，组间比较有显著性差异（ Ｓ１ 对 Ｓ１ ＋ Ｓ２ ， Ｐ＜ ０ ．００１ ， Ｓ１ ＋ Ｓ２ 对 Ｓ１ ＋ Ｓ２ ＋ Ｓ３ ， Ｐ＜ ０ ．０５） 。对５４ 例仍未能诱发者静注阿托品后重复试验又诱发出３４ 例，最后还有２０ 例（１１ ．１ ％ ） 不能诱发。比较用阿托品前后总的诱发成功率，差异极显著（ Ｐ＜ ０ ．００１） 。结论 Ｔ Ｅ Ａ Ｐ 单用 Ｓ１ 刺激诱发成功率低，加用 Ｓ２ 尤其是 Ｓ３
To evaluate the effect of stimulating modes in transesophageal atrial pacing(TEAP) and intravenous administration of atropine on induce of paroxysmal supraventricular tachycardia,to probe how to improve its successfulness.Method: 180 cases who clinically had or suspiciously had PSVT were examined with TEAP.At baseline,S1S1 stimulating mode(S1) and S1S2 mode(S2) were applied first,then unsuccessful cases underwent S1S2S3 stimulating mode(S3).Patients which could not be induced by all of above modes received a dosage of intravenous injection of atropine(0.02 mg/kg),after approximate 5 minutes underwent repeated tests.Result:at baseline 126 of 180 cases were induced including S1 group 40(22.2%),S1+S2 group 104(57.8%),and S1+S2+S3 group 126(70.0%).Differences are statistically significant(P<0.001 in S1 vs S1+S2,P<0.05 in S1+S2 vs S1+S2+S3).Thirty four of Fifty four cases which were unsuccessful baseline were induced successfully after intravenous atropine.Significant difference of total inducible incidence of PSVT was observed between baselin and after application of atropine(P<0.001).Conclusion:Simply applied S1 mode in TEAP has the lowest inducible incidence of PSVT,where as simultenously using S2 and especially S3 can significantly improve induce of successfulness.Intravenous injection of atropine has important significance in duplication of PSVT by TEAP.
关键词
食道心房调搏
阿托品
室上性
心动过速
刺激方式
transesophageal atrial pacing
atropine
supraventricular tachycardia stimulating mode
