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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Decremental ramp atrial extrastimuli pacing protocol for the induction of atrioventricular nodal re-entrant tachycardia and other supraventricular tachycardias.
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Decremental ramp atrial extrastimuli pacing protocol for the induction of atrioventricular nodal re-entrant tachycardia and other supraventricular tachycardias.

机译：减少斜道房性心外刺激起搏方案，用于诱发房室结折返性心动过速和其他室上性心动过速。

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AIM: The primary aim of this study was to evaluate the utility of decremental ramp atrial extrastimuli pacing protocol (PRTCL) for induction of atrioventricular nodal re-entrant tachycardia (AVNRT), and other supraventricular tachycardias (SVTs), compared to standard (STD) methods. METHODS: The study cohort of 121 patients (age 57.51 +/- 14.02 years) who presented with documented SVTs and/or symptoms of palpitations and dizziness, and underwent invasive electrophysiological evaluation was divided into Group I (AVNRT, n = 42) and Group II (Control, n = 79). The PRTCL involved a train of six atrial extrastimuli, delivered in a decremental ramp fashion. The STD methods included continuous burst and rapid incremental pacing up to atrioventricular (AV) block cycle length, and single and occasionally double atrial extrastimuli. Prolongation in the Atrio-Hisian (Delta-AH) intervals achieved by both methods were compared, as were induction frequencies. RESULTS: In Group I, three categories of responses--(1) induction of AVNRT, (2) induction of echo beats only, and (3) none--were observed in 29 (69%), 11 (26%), and 2 (5%) patients with the PRTCL, when compared with 14 (33%), 16 (38%), and 12 (29%) patients with STD methods in the baseline state without the use of pharmacological agents. The Delta-AH intervals for each of these three categories were larger using PRTCL versus STD methods; 293.3 +/- 95.2 ms versus 192.9 +/- 61.4 ms (P < 0.005), 308.6 +/- 68.5 ms versus 189. 9 +/- 64.9 ms (P < 0.0005), and 203.0 +/- 86.3 ms versus 145.8 +/- 58.9 ms (P = NS), respectively. In Group II, in one patient with dual AV nodal physiology but no clinical tachycardia, the PRTCL induced nonsustained (12 beats) AVNRT. Additionally, in this group, both PRTCL and STD methods induced atrial tachycardia in two patients and orthodromic AV re-entrant tachycardia in one patient. CONCLUSION: Decremental ramp atrial extrastimuli pacing PRTCL demonstrates a superior response for induction of typical AVNRT as compared to STD techniques. Because of easy and reliable induction of AVNRT and echo beats by the PRTCL, we recommend it as a method to increase the likelihood of induction of AVNRT. For induction of other SVTs, the PRTCL and the STD methods are comparable.
机译：目的：本研究的主要目的是评估与标准（STD）相比，递减的斜房房室外刺激起搏协议（PRTCL）诱发房室结折返性心动过速（AVNRT）和其他室上性心动过速（SVT）方法。方法：本研究队列的121名患者（年龄57.51 +/- 14.02岁）表现出已记录的SVT和/或心pal和头晕症状，并进行了有创电生理评估，分为I组（AVNRT，n = 42）和I组II（对照，n = 79）。 PRTCL涉及一系列以减量斜波方式交付的六个心房外刺激。 STD方法包括连续爆发和快速递增起搏直至房室（AV）阻滞周期长度，以及单次和偶发双次房性刺激。比较了两种方法在Atrio-Hisian（Delta-AH）间隔中的延长时间以及感应频率。结果：在第一组中，在29（69％），11（26％）中观察到三类响应-（1）诱发AVNRT，（2）仅诱发回声搏动，（3）没有反应，和2（5％）的PRTCL患者相比，有14（33％），16（38％）和12（29％）处于基线状态且未使用药物的STD方法患者。使用PRTCL和STD方法，这三个类别中的每一个的Delta-AH间隔都较大; 293.3 +/- 95.2 ms与192.9 +/- 61.4 ms（P <0.005），308.6 +/- 68.5 ms与189. 9 +/- 64.9 ms（P <0.0005）和203.0 +/- 86.3 ms与145.8 + /-58.9 ms（P = NS）。在第二组中，在一位具有双重AV节点生理学但没有临床心动过速的患者中，PRTCL诱导了非持续性（12次搏动）AVNRT。此外，在该组中，PRTCL和STD方法均在2例患者中诱发了房性心动过速，而在1例患者中采用了正畸AV折返性心动过速。结论：与STD技术相比，递减性斜道房性心律失常起搏PRTCL显示出对典型AVNRT诱导的优异反应。由于PRTCL可以轻松可靠地诱发AVNRT和回波，因此我们建议将其作为增加诱发AVNRT可能性的方法。对于其他SVT的感应，PRTCL和STD方法是可比的。

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