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目的:32例接受导管射频消融治疗后的阵发性室上性心动过速患者,均无器质性心脏病。分别进行高位右心房(HRA)部位快速右心房起搏(AP)、右心室心尖部(RVA)快速心室起搏(RVP)、HRA+RVA部位房室同时起搏(SAVPHRA+RVA)以及冠状窦远端(CSd)+RVA部位房室同步起搏(SAVPCSd+RVA),起搏周长均为400ms,持续时间各5min。分别测量不同起搏方式起搏前后右心房压力。结果:与窦性节律(SR)时比较,AP对心房压力无明显影响[(9.1±4.4):(7.3±3.3)cmH2O,P>0.05];与SR及AP比较,RVP、SAVPHRA+RVA、SAVPCSd+RVA使心房压力升高[(13.5±4.2)、(12.7±4.5)、(14.7±3.8)cmH2O,P<0.01];RVP和SAV-PHRA+RVA、SAVPCSd+RVA等不同起搏方式升高心房压力作用基本相当(P>0.05)。结论:单纯RVP及SAVP均升高心房压力,作用相当,但单纯RVP使观察心房机械电反馈时结果更加客观,方法更简便,是替代SAVP研究心房机械电反馈的理想方法。
PURPOSE: Thirty-two patients with paroxysmal supraventricular tachycardia who underwent radiofrequency catheter ablation had no organic heart disease. Rapid right atrial pacing (AP), right ventricular apex (RVA) rapid ventricular pacing (RVP), HRA + RVA atrioventricular pacing (SAVPHRA + RVA) and coronary sinus The distal ventricular (CSd) + RVA part of the atrioventricular synchronized pacing (SAVPCSd + RVA), pacing circumference are 400ms, the duration of each 5min. Different pacing methods were measured before and after pacing the right atrial pressure. Results: Compared with SR, AP had no significant effect on atrial pressure (9.1 ± 4.4 vs 7.3 ± 3.3 cmH2O, P> 0.05). Compared with SR and AP, RVP, SAVPHRA + RVA, SAVPCSd + RVA increased atrial pressure [(13.5 ± 4.2), (12.7 ± 4.5), (14.7 ± 3.8) cmH2O, P <0.01]; different pacing modes such as RVP and SAV-PHRA + RVA and SAVPCSd + High atrial pressure basically the same (P> 0.05). CONCLUSIONS: RVP alone and SAVP both increase atrial pressure, but their effect is quite similar. However, RVP makes the observation of atrial mechanical and electrical feedback more objective and simpler, which is an ideal alternative to SAVP for atrial mechano-electrical feedback.