Involvement of a Nodofascicular Connection in Supraventricular Tachycardia with VA Dissociation
Involvement of a Nodofascicular Connection in Supraventricular Tachycardia with VA Dissociation
复制标题
结束连接参与室上性心动过速伴 VA 分离
DOI：
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发表时间：
1994
期刊：
影响因子：
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通讯作者：
J. Clémenty
中科院分区：
文献类型：
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作者：
M. Haïssaguerre;J. Campos;F. Marcus;G. Papouin;J. Clémenty
SVT的结节束状连接。我们提出的情况下，患者发作室上性心动过速和心房游离，终止由腺苷或维拉帕米。辅助通路的参与通过心室外刺激显示，在他束难耐期间引起，可中断心动过速或提前下一个他束电位。在排除周围组织的基础上，证明心动过速回路局限于结节束区。心房活动，包括结周区心房活动，在心动过速时完全分离。电路的最低部分位于希氏分叉上方，因为在心动过速期间多次发作的左束或右束分支结构并没有改变HH周期。由于在心动过速或心房起搏期间未出现预兴奋，并且右束分支不属于电路的一部分，因此确定室间隔顶点不受影响。射频电流应用于三尖瓣下的he区，成功地消除了节束连接，并保留了1:1的房室传导。异常连接的解剖学基础可能是结节束-脑室Mahaim纤维，也可能是结节-脑室传导系统的二元性或分散性。
Nodofascicular Connection in SVT. We present the case of a patient with episodes of supraventricular tachycardia and atrial dissociation that were terminated by either adenosine or verapamil. Involvement of an accessory pathway was shown by ventricular extrastimuli, elicited during His‐bundle refractoriness, that interrupted the tachycardia or advanced the next His potential. The tachycardia circuit was demonstrated to he confined to the nodofascicular region based on the exclusion of surrounding tissues. Atrial activity, including that in the perinodal region, was totally dissociated during tachycardia. The lowest part of the circuit was determined to be located above the Hisian bifurcation, as multiple episodes with either a right or left bundle branch configuration during tachycardia did not modify the HH cycle. The ventricular septum summit was determined not to be involved, as no preexcitation was present during tachycardia or atrial pacing, and the right bundle branch was not part of the circuit. Radiofrequency current applied beneath the tricuspid valve at the His region successfully eliminated the nodofascicular connection with preservation of 1:1 AV conduction. The anatomical substrate underlying the abnormal connection may be either nodofasciculoventricular Mahaim fibers or a duality or dispersion of the nodo‐Hisian conducting system.
使用结束 Mahaim 纤维的心动过速机制。
DOI：
10.1016/s0002-9149(84)80163-0
发表时间：
1984
期刊：
The American journal of cardiology
影响因子：
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作者：
Bardy,GH;German,LD;Packer,DL;Coltorti,F;Gallagher,JJ
通讯作者：
Gallagher,JJ