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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >The electrophysiological characteristics in patients with ventricular stimulation inducible fast-slow form atrioventricular nodal reentrant tachycardia.
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The electrophysiological characteristics in patients with ventricular stimulation inducible fast-slow form atrioventricular nodal reentrant tachycardia.

机译：心室刺激诱发的快慢型房室结折返性心动过速患者的电生理特征。

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摘要

BACKGROUND: Atrioventricular nodal reentrant tachycardia (AVNRT) can usually be induced by atrial stimulation. However, it seldom may be induced with only ventricular stimulation, especially the fast-slow form of AVNRT. The purpose of this retrospective study was to investigate the specific electrophysiological characteristics in patients with the fast-slow form of AVNRT that could be induced with only ventricular stimulation. METHODS: The total population consisted of 1,497 patients associated with AVNRT, and 106 (8.4%) of them had the fast-slow form of AVNRT and 1,373 (91.7%) the slow-fast form of AVNRT. In patients with the fast-slow form of AVNRT, the AVNRT could be induced with only ventricular stimulation in 16 patients, Group 1; with only atrial stimulation or both atrial and ventricular stimulation in 90 patients, Group 2; and with only atrial stimulation in 13 patients, Group 3. We also divided these patients with slow-fast form AVNRT (n = 1,373) into two groups: those that could be induced only by ventricular stimulation (Group 4; n = 45, 3%) and those that could be induced by atrial stimulation only or by both atrial and ventricular stimulation (n = 1.328, 97%). RESULTS: Patients with the fast-slow form of AVNRT that could be induced with only ventricular stimulation had a lower incidence of an antegrade dual AVN physiology (0% vs 71.1% and 92%, P < 0.001), a lower incidence of multiple form AVNRT (31% vs 69% and 85%, P = 0.009), and a more significant retrograde functional refractory period (FRP) difference (99 +/- 102 vs 30 +/- 57 ms, P < 0.001) than those that could be induced with only atrial stimulation or both atrial and ventricular stimulation. The occurrence of tachycardia stimulated with only ventricular stimulation was more frequently demonstrated in patients with the fast-slow form of AVNRT than in those with the slow-fast form of AVNRT (15% vs 3%, P < 0.001). Patients with the fast-slow form of AVNRT that could be induced with only ventricular stimulation had a higher incidence of retrograde dual AVN physiology (75% vs 4%, P < 0.001), a longer pacing cycle length of retrograde 1:1 fast and slow pathway conduction (475 +/- 63 ms vs 366 +/- 64 ms, P < 0.001; 449 +/- 138 ms vs 370 +/- 85 ms, P = 0.009), a longer retrograde effective refractory period of the fast pathway (360 +/- 124 ms vs 285 +/- 62 ms, P 0.003), and a longer retrograde FRP of the fast and slow pathway (428 +/- 85 ms vs 362 +/- 47 ms, P < 0.001 and 522 +/- 106 vs 456 +/- 97 ms, P 0.026) than those with the slow-fast form of AVNRT that could be induced with only ventricular stimulation. CONCLUSION: This study demonstrated that patients with the fast-slow form of AVNRT that could be induced with only ventricular stimulation had a different incidence of the antegrade and retrograde dual AVN physiology and the specific electrophysiological characteristics. The mechanism of the AVNRT stimulated only with ventricular stimulation was supposed to be different in patients with the slow-fast and fast-slow forms of AVNRT.
机译：背景：房室结折返性心动过速（AVNRT）通常可通过心房刺激来诱发。但是，仅通过心室刺激（尤其是AVNRT的快慢形式）很少会诱发这种情况。这项回顾性研究的目的是研究仅通过心室刺激即可诱发的AVNRT快慢型患者的特定电生理特征。方法：总人口包括1,497例AVNRT相关患者，其中106例（8.4％）患有AVNRT的快慢型，1,373例（91.7％）患有AVNRT的慢速型。在AVNRT快慢型患者中，只有16例患者的心室刺激可以诱发AVNRT，第1组。第2组90例仅接受房室刺激或同时进行房室和心室刺激治疗;且只有心房刺激的患者为第3组，第3组。我们还将这些慢速型AVNRT患者（n = 1,373）分为两组：仅由心室刺激引起的患者（组4; n = 45，3 ％）以及仅通过心房刺激或通过心房和心室刺激均可诱发的那些（n = 1.328，97％）。结果：仅通过心室刺激即可诱发的AVNRT快慢型患者发生顺行性双重AVN生理学的发生率较低（0％比71.1％和92％，P <0.001），多种形式的发生率较低AVNRT（31％vs 69％和85％，P = 0.009），逆行功能不应期差异（99 +/- 102 vs 30 +/- 57 ms，P <0.001）仅通过心房刺激或同时进行心房和心室刺激即可诱发。在AVNRT的快慢型患者中，仅由心室刺激引起的心动过速的发生率要高于AVNRT的慢速型患者（15％vs 3％，P <0.001）。仅通过心室刺激即可诱发的AVNRT快慢型患者逆行双重AVN生理学发生率较高（75％vs 4％，P <0.001），逆行1：1快速起搏周期长度更长，慢通道传导（475 +/- 63 ms vs 366 +/- 64 ms，P <0.001; 449 +/- 138 ms vs 370 +/- 85 ms，P = 0.009），较快的逆行有效不应期通道（360 +/- 124 ms与285 +/- 62 ms，P 0.003），以及快速和慢通道的较长逆行FRP（428 +/- 85 ms与362 +/- 47 ms，P <0.001和522 +/- 106 vs 456 +/- 97 ms，P 0.026），而那些仅通过心室刺激即可诱发的AVNRT慢速型患者。结论：这项研究表明，仅通过心室刺激即可诱发的AVNRT快慢型患者，发生顺行和逆行双重AVN生理和特定电生理特征的发生率不同。慢速和快慢形式的AVNRT患者被认为仅由心室刺激刺激的AVNRT的机制是不同的。

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