食管心房调搏对诊断房室传导阻滞的应用.pdfVIP

[摘要】 目的 评价食管心房调搏对于房室传导阻滞的诊断价值。 方法 比较145例心动过缓患者采用食管 心房调搏与常规／动态心电图对于房室传导阻滞的检出率并进行随访。 结果 (1)食管心房调搏对房室传导阻滞的 检出率(66．9％)高于常规／动态心电图(51 7％)，差异有显著性意义(P0．05 o(2)阿托品试验前后食管心房调搏对房 室传导阻滞的检出率(77．9％，66．9％)差异有显著性意义(尸O．05)。(3)经6～24月随访食管心房调搏检出的22例早期 病理性房室传导阻滞患者19例发展为典型房室传导阻滞。 结论 食管心房调搏对房室传导阻滞等缓慢性心律失 常的诊断和鉴别诊断同样具有临床实用价值。 [关键词】食管心房调搏； 房室传导阻滞； 窦性心动过缓 [中图分类号】R541．7 6；R540．4 1 [文献标识码】A [文章编号】 1002—1094(2008)01—0077—02 Application of TransesophageaI Atrial Pacing in Diagnosis of Atrioventricular Block QUA N Tie，LIA NG Chuanliang， LV Q shah，et a1．Department ofElectrocardiogram，The People’5 Hospita!ofShimen County．Hunan，415300,China Corresponding author：QUAN孔e，E—mail：cathayblous@126．com 【Abstract】 Objective To appraise application of Transesophageal atrial pacing(TEAP)in diagnosis of atrioven— tricular block(AVB)．Methods Sensitivities of TEAP and routine or dynamic electrocardiogram(ECG)in diagnosing AVB were compared in 1 45 patients with sinus bradycardia．Results (1)The sensitivity of TEAP in diagnosing AVB was higher than that of routine or dynamic ECG (66．9％VS 51_7％，P0．05)．(2)7he sensitivity of TEAP in diagnosing AVB increased significantly from 66．9％ before to 77．9％ after intravenous injection of atropine(P0．05)．f3)1 9 of 22 patients diagnosed as pre—AVB developed AVB during following 6-24 months． Conclusion TEAP is a useful method in diagnosis and prediction of AVB 【Key words】 Transesophageal atrial pacing； Atrioventricular block； Sinus bradycardia 房室传导阻滞临床上常有头晕、乏力等自觉症 2．方法 食管心房调搏仪采用苏州东方电子 状，常规／动态心电图上有时与窦性心动过缓难以 仪器厂产DF一5A型心脏电生理刺激仪，常规心电图 鉴别。本文比较食管心房调搏与常规／动态心电图 和食管导联心电图采用上海光电医用电子仪器有限 对145例窦性心动过缓或房室传导阻滞患者的诊断 公司产ECG一651 1型单导联心电图机记录，动态心 结果。 电图采用北京美高仪软件技术有限公司产MGY— H7动态分析系统。所有患者在行食管心房调搏前均 资料和方法