Variation of P-QRS relation during atrioventricular node reentry tachycardia
Variation of P-QRS relation during atrioventricular node reentry tachycardia
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DOI：
10.1016/s0735-1097(98)00576-2
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发表时间：
1999-02-01
影响因子：
24
通讯作者：
Wu, D
中科院分区：
文献类型：
--
作者：
Taniguchi, Y;Yeh, SJ;Wu, D
目的探讨房室结折返性心动过速时P-QRS关系的变化现象。背景房室结折返性心动过速时P-QRS关系的变化。方法对311例慢快型房室结折返性心动过速患者和108例不典型或多发性房室结折返性心动过速患者的P-QRS变化与房室结折返性心动过速时AH、HA及AH/HA(A=心房；H=希氏束)比值变化的关系进行回顾性分析。男6例，女22例，平均年龄38±16岁。在10名患者中，这种现象在电诱导心动过速后一过性发生。在15例患者中，AH、HA和AH/HA比值的改变与文克巴赫或希氏束(H)记录部位近端2：1传导阻滞的发生有关，而不中断心动过速。在9名患者中，3名患者患有非持续性心动过速，6名患者服用三磷酸腺苷后，在心动过速终止时观察到这种现象。结论房室结折返性心动过速时，尤其是不典型或多形性心动过速时，P-QRS关系可发生改变。据推测，在折返回路的远端链接和H之间存在的远端共同通路中的递减传导是造成这种现象的主要原因。(C)1999年由美国心脏病学会颁发。
OBJECTIVES The main objective of this study was to characterize the phenomenon of variation in the P-QRS relation during atrioventricular node reentry tachycardia.BACKGROUND Variation of P-QRS relation during tachycardia has been observed occasionally in atrioventricular node reentry tachycardia. However, the incidence, the characteristics and the mechanisms of this phenomenon have not been investigated previously.METHODS Retrospective analysis was performed in 311 consecutive patients with slow-fast form and 108 patients with atypical or multiple form of atrioventricular node reentry tachycardia to examine whether variation of P-QRS relation with changes in AH, HA and AH/HA (A = atria; H = His bundle) ratio occurred during tachycardia.RESULTS A total of 28 patients, 8 with slow-fast and 20 with atypical or multiple tachycardias, were found to manifest this phenomenon. There were 6 males and 22 females, with an average age of 38 +/- 16 years. In 10 patients, this phenomenon occurred transiently following electrical induction of the tachycardia. In 15 patients, changes in AH, HA and AH/HA ratio were associated with the occurrence of Wenckebach or 2:1 block proximal to the His bundle (H) recording site without interruption of the tachycardia. In nine patients, three with nonsustained tachycardia and six after administration of adenosine triphosphate, this phenomenon was observed at the termination of the tachycardia. This phenomenon was usually accompanied by a mild lengthening of the tachycardia cycle length.CONCLUSIONS Variation of P-QRS relation with or without block may occur during atrioventricular node reentry tachycardia, especially in atypical or multiple-form tachycardias. It was postulated that decremental conduction in the distal common pathway, which exists between the distal link of the reentry circuit and the H, is primarily responsible for this phenomenon. (C) 1999 by the American College of Cardiology.