Entrainment of atrioventricular nodal reentrant tachycardias during overdrive pacing from high right atrium and coronary sinus. With special reference to atrioventricular dissociation and 2:1 retrograde block during tachycardias.
Entrainment of atrioventricular nodal reentrant tachycardias during overdrive pacing from high right atrium and coronary sinus. With special reference to atrioventricular dissociation and 2:1 retrograde block during tachycardias.
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从高位右心房和冠状窦超速起搏期间夹带房室结折返性心动过速。
DOI：
10.1016/0002-9149(84)90581-2
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
Agustin Castellanos
中科院分区：
文献类型：
--
作者：
Bolivar Portillo;J. Mejias;N. Leon;Liaqat Zaman;R. J. Myerburg;Agustin Castellanos
在对8例房室结折返性心动过速患者进行电生理评价时尝试了夹带。从高位右心房起搏35次，从近端冠状窦起搏9次，从远端冠状窦起搏10次。所需的最低心率比心动过速的心率快8 ~ 40次/min。在心动过速期间，发生短时间房室分离和1次2：1逆行阻滞，表明心房（如电生理学研究中所定义）不是折返回路的必要组成部分。为了使心动过速中断，起搏频率通常必须略快于所需的牵拉频率，并且足够快以在慢房室结通路中产生心房冲动的顺行阻滞。此外，心动过速的终止显然是起搏部位的功能。在某些发作中，由于邻近效应或由于优先输入上共同通路，冠状窦起搏终止心动过速的速率较慢，或刺激较少，而不是高右心房起搏。因此，耐药房室结折返性心动过速患者可能受益于最近推出的起搏技术，通过夹带终止心动过速。
Entrainment was attempted during electrophysiologic evaluation of 8 patients with atrioventricular (AV) nodal reentrant tachycardia. Entrainment could be performed while pacing from the high right atrium in 35 of 35 episodes, from proximal coronary sinus in 9 of 21 episodes and from distal coronary sinus in 10 of 20 episodes. The minimal rates required were 8 to 40 beats/min faster than those of the tachycardias. That the atria (as defined in electrophysiologic studies) were not a necessary component of the reentry circuit was suggested by the occurrence, during tachycardia, of short episodes of AV dissociation and of 1 episode of 2:1 retrograde block. For the tachycardia to be interrupted, the pacing rate usually had to be slightly faster than that required to entrain, as well as sufficiently rapid to produce anterograde block of an atrial impulse in the slow AV nodal pathway. Moreover, termination of tachycardia apparently was a function of the pacing site. In some episodes, either because of a proximity effect or because of a preferential input into the upper common pathway, coronary sinus pacing terminated the tachycardia at slower rates or with fewer stimuli than high right atrial pacing. Thus, patients with drug-resistant AV nodal reentrant tachycardias may benefit from recently introduced pacing techniques for termination of tachycardia through entrainment.