Mechanisms of transition between double paroxysmal supraventricular tachycardias
Mechanisms of transition between double paroxysmal supraventricular tachycardias
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DOI：
10.1046/j.1540-8167.2001.01339.x
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发表时间：
2001-12-01
影响因子：
2.7
通讯作者：
Chen, SA
中科院分区：
文献类型：
--
作者：
Kuo, JY;Tai, CT;Chen, SA
双重阵发性室上性心动过速。导言：一个患者同时存在两个心动过速的报道并不多见。此外，双发阵发性室上性心动过速之间的转归机制还没有得到很好的研究。方法和结果：对35例两个阵发性室上性心动过速患者进行研究。IA组包括3例房室折返性心动过速(AVRT)和房室结折返性心动过速(AVNRT)的自发转换。IB组13例，房室折返性心动过速与房室结折返性心动过速之间无自发转换。IIA组：AVNRT和房性心动过速(AT)自发转折组5例。1113组：14例AVNRT和AT无自发转复的患者。两种心动过速患者的心动过速周期之差绝对值分别为25+/-8毫秒比90+/-46毫秒(P<；0.05，IA比IB；21+/-25毫秒比99 57毫秒，P<；0.01，IIA比IIB)。以25毫秒为临界点，对两种心动过速的转移率有80%的阳性预测值。两个心动过速之间的转换是由于自发性房性早搏(30%)、单肢传导阻滞(20%)或心动过速引起的心动过速(50%)。两个心动过速之间没有过渡的原因可能是没有自发的房性早搏，第一个心动过速的周长较长，两个心动过速的周长相差较大，或者在不同的情况下诱发两个心动过速。结论：双重室上性心动过速的心动过速周期长度相近，容易在不同的心动过速之间过渡。
Double Paroxysmal Supraventricular Tachycardias. Introduction: Coexistence of double tachycardias in one patient has been infrequently reported. Furthermore, the mechanisms of transition between double paroxysmal supraventricular tachycardias have not been well studied.Methods and Results: Thirty-five patients with two paroxysmal supraventricular tachycardias were studied. Group IA consisted of 3 patients with spontaneous transition between AV reciprocating tachycardia (AVRT) and AV nodal reentrant tachycardia (AVNRT). Group IB consisted of 13 patients without spontaneous transition between AVRT and AVNRT. Group IIA consisted of 5 patients with spontaneous transition between AVNRT and atrial tachycardia (AT). Group 1113 consisted of 14 patients without spontaneous transition between AVNRT and AT. The absolute values of differences between the two tachycardia cycle lengths were significantly smaller in patients with than in those without transition between the two tachycardias (25 +/- 8 msec vs 90 +/- 46 msec, P < 0.05, IA vs IB; 21 +/- 25 msec vs 99 57 msec, P < 0.01, IIA vs IIB). The cutoff point of 25 msec had 80% positive predictive value for transition between the two tachycardias. Transition between two tachycardias occurred due to a spontaneous premature atrial complex (30%), conduction block at one limb of tachycardia (20%), or tachycardia-induced tachycardia (50%). Absence of transition between two tachycardias might be explained by the absence of a spontaneous premature atrial complex, longer cycle length of the first tachycardia, larger difference between two tachycardia cycle lengths, or induction of each tachycardia under different situations.Conclusion: Double supraventricular tachycardias with similar tachycardia cycle lengths are vulnerable to transition between different tachycardias.