Changes in cycle length at the onset of sustained tachycardias--importance for antitachycardiac pacing.
Changes in cycle length at the onset of sustained tachycardias--importance for antitachycardiac pacing.
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持续性心动过速发作时周期长度的变化——抗心动过速起搏的重要性。
DOI：
10.1016/0002-8703(88)90808-3
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发表时间：
1988
影响因子：
4.8
通讯作者：
P. Brugada
中科院分区：
文献类型：
--
作者：
A. Geibel;M. Zehender;P. Brugada
我们分析了持续性单形性室性心动过速（VT）、房室结性心动过速（AVNT）和包含旁路的环状运动性心动过速（CMT）电生理启动后前100次搏动期间持续性心动过速的自发周期长度的变化。VT的平均周期长度为288 ± 75 msec，AVNT的该值为388 ± 63 msec，CMT的该值为348 ± 76 msec。开始后，在所有三种类型的心动过速中，观察到周期长度的变化高达± 15%至25%。室性心动过速患者的周期长度变化范围为+12%至-18%，AVNT患者为+17%至-15%，CMT患者为+17%至-15%。前100次心动过速的平均变化百分比为7.0 ± 4.7%（VT）、9.5 ± 5.4%（AVNT）和8.3 ± 5.4%（CMT）。VT和AVNT患者的心动过速发生率均呈恒定的增加或减少或改变。没有一例CMT患者在开始治疗后周期长度持续减少。室性心动过速患者达到最大周期长度增加或减少的平均时间为13 ± 6和11 ± 9秒，房室结患者为16 ± 3和20 ± 7秒。在CMT患者中，达到最大增加（10 ± 7秒）或减少（20 ± 9秒）的平均时间差异显著。这些结果表明，在所有类型的持续性心动过速，心动过速开始后的周期长度的变化是一个共同的发现，并仔细考虑抗心动过速起搏系统的设计时。
We analyzed changes in the spontaneous cycle length of sustained tachycardia during the first 100 beats after electrophysiologic initiation of sustained monomorphic ventricular tachycardia (VT), atrioventricular nodal tachycardia (AVNT), and circus movement tachycardia incorporating an accessory pathway (CMT). The mean cycle length of VT was 288 ± 75 msec, for AVNT this value was 388 ± 63 msec, and for CMT this value was 348 ± 76 msec. After initiation, in all three types of tachycardia changes in cycle length of up to ± 15% to 25% were observed. The changes in cycle length ranged from +12% to −18% in patients with VT, from +17% to −15% in patients with AVNT, and from +17% to −15% in patients with CMT. The mean percentage of changes during the first 100 beats of tachycardia was 7.0 ± 4.7% (VT), 9.5 ± 5.4% (AVNT) and 8.3 ± 5.4% (CMT). Patients with VT and AVNT showed both a constant increase or decrease or alteration of the rate of tachycardia. In no patient with CMT was there a constant decrease in cycle length after initiation. The mean time to achieve the maximal increase or decrease in cycle length was 13 ± 6 and 11 ± 9 seconds in patients with VT and 16 ± 3 and 20 ± 7 seconds in patients with AVNT. In patients with CMT, the mean time to achieve the maximal increase (10 ± 7 seconds) or decrease (20 ± 9 seconds) varied markedly. These results indicate that in all types of sustained tachycardia, changes in cycle length after initiation of the tachycardia are a common finding and have to be carefully considered when antitachycardia pacing systems are designed.