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经食管心房调搏进行心脏负荷试验是诊断早期冠心病的有效方法之一。我们对26例疑为早期冠心病且运动负荷试验阴性或可疑、部分常规心电图异常而心得安试验阳性的患者进行凋搏检查,获满意效果。1 一般资料 26例中男19例,女7例;年龄40～65岁,平均46岁。除具有1～2项易患因素外(高血脂、糖耐量异常、高血压、吸咽),多数有不典型心绞痛发作。2 检查方法 术前停用对心脏有影响的药物至少48小时。用食管起搏器以S_1—S_1法分级起搏,起搏频率140～160次/分,以观察能否诱发ST-T改变或心绞痛发作。3诊断标准 ①调搏后心电图即刻出现缺血型ST段下降>0.75mV;②调搏后头3个波形出现缺血型ST段下降>1.0mV;③缺血型ST段下降>0.5mV持续2分钟;④调搏中诱发心绞痛。凡具备上述之一者即为阳性。
Transcatheter atrial pacing for cardiac stress test is an effective method to diagnose early coronary heart disease. We have 26 patients suspected of early coronary heart disease and exercise load test was negative or suspicious, some of the conventional ECG abnormality and propranolol test positive in patients with apoptosis test, satisfactory results. 1 General Information 26 cases of male 19 cases, 7 females; aged 40 to 65 years, mean 46 years. In addition to having 1 or 2 predisposing factors (hyperlipemia, impaired glucose tolerance, hypertension, swallowing), most have episodes of atypical angina. 2 check the method of preoperative withdrawal of heart-affecting drugs for at least 48 hours. Esophageal pacemaker to S_1-S_1 grading pacing, pacing rate of 140 to 160 beats / min, to observe whether the change induced by ST-T or angina pectoris. 3 diagnostic criteria ① immediately after twitch electrocardiogram ischemic ST segment decline> 0.75mV; ② after the first three pacing wave of ischemic ST segment decreased> 1.0mV; ③ ischemic ST segment drop> 0.5mV sustained 2 Minute; ④ pacing induced angina pectoris. Those who have one of the above are positive.