Study on the mechanism of atrioventricular reentrant tachycardia with RR interval alternation

中国综合临床 Pub Date : 2020-03-01 DOI:10.3760/CMA.J.ISSN.1008-6315.2020.02.010

Wenhua Lin, C. Di, P. Gao, Qun Wang

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引用次数: 0

Abstract

Objective To explore the mechanism of the alternation of RR interval length in atrioventricular reentrant tachycardia (AVRT). Methods From August 2009 to August 2016, 317 patients with AVRT were treated by radiofrequency catheter ablation in cardiology department of TEDA International Cardiovascular Hospital were analyzed retrospectively.During AVRT, 5 mg of verapamil was given slowly intravenously for 10 min.After administration, the changes of RR interval, AH interval, HV interval and VA interval were observed and the time of changes was also observed. Results After administration of verapamil, there were 8 patients with RR interval alternation and QRS wave alternation.When RR interval alternation occurred, the difference of AH interval between adjacent heart beats was gradually extended, without AH jump, and the HV interval and VA interval were constant.This phenomenon occurred 6-17 minutes after administration, and the average cycle of tachycardia was 16-42 ms longer than before administration.In 3 patients, RR interval alternation occurred.When the phenomenon disappeared, the difference of AH interval between adjacent heart beats was gradually shortened, there was no AH jump, and the interval between HV and VA was constant until AH interval was equal, the disappearance time was 19-57 min after administration; AVRT was terminated in 5 patients after administration. Conclusion It can be concluded that the mechanism is due to the frequency dependent decreasing conduction of AH interval in tachycardia, which can not be induced by program stimulation. Key words: Verapamil; Atrioventricular reciprocating tachycardia; Electrophysiology; Catheter ablation; RR interval alternative

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房室折返性心动过速伴RR间期交替的发病机制研究

目的探讨房室折返性心动过速(AVRT) RR间期长短变化的机制。方法回顾性分析2009年8月至2016年8月泰达国际心血管医院心内科射频导管消融治疗AVRT患者317例。AVRT期间，维拉帕米5 mg缓慢静脉滴注10 min，给药后观察RR间期、AH间期、HV间期、VA间期的变化及变化时间。结果维拉帕米治疗后，8例患者出现RR间期交替和QRS波交替。当发生RR间期交替时，相邻心跳间期AH差逐渐扩大，无AH跳变，HV间期和VA间期保持不变。该现象发生于给药后6 ~ 17 min，平均心动过速周期较给药前延长16 ~ 42 ms。3例患者出现RR间期交替。当该现象消失后，相邻心跳间期AH差逐渐缩短，AH无跳跃，HV与VA间期保持不变，直至AH间期相等，给药后消失时间为19 ~ 57 min;5例患者给药后AVRT终止。结论其机制可能与心动过速AH间期传导频率依赖性降低有关，而非程序性刺激所致。关键词:维拉帕米;房室往复式心动过速;电生理学;导管消融;RR区间选择

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来源期刊

中国综合临床

CiteScore

0.10

自引率

0.00%

发文量

16855

期刊介绍： Clinical Medicine of China is an academic journal organized by the Chinese Medical Association (CMA), which mainly publishes original research papers, reviews and commentaries in the field. Clinical Medicine of China is a source journal of Peking University (2000 and 2004 editions), a core journal of Chinese science and technology, an academic journal of RCCSE China Core (Extended Edition), and has been published in Chemical Abstracts of the United States (CA), Abstracts Journal of Russia (AJ), Chinese Core Journals (Selection) Database, Chinese Science and Technology Materials Directory, Wanfang Database, China Academic Journal Database, JST Japan Science and Technology Agency Database (Japanese) (2018) and other databases.