经食道心房调搏术及食道心电图在心律失常中的应用

目的:分析经食道心房调搏术(TEAP)及食道内心电图(EECG)在心律失常中的应用价值。方法:选取2018年6月至2019年12月于我院行食道心电图及经食道调搏的患者189例,其中男80例,女109例,年龄11~83岁。结果:54例为房室结折返性心动过速(AVNRT),34例为房室折返性心动过速(AVRT),8例为房性心动过速(AT),4例为心房扑动(AF),6例为心房颤动(Af),5例为室性心过速,78例为室早或其他。共105例心律失常患者拟行食道心房调搏终止心动过速,所有AVNRT和AVRT患者及17例AT患者经食道心房调搏S1S1成功转为窦律,50例AVNRT、32例AVRT、6例AT、3例AF及2例VT患者通过射频消融术成功根治。其中1例11岁AT患者因无法耐受食道调搏,未能转为窦律,患者经静推普罗帕酮后次日转为窦律。共97例患者拟行食道心房调搏诱发,共49例诱发出心动过速,1例左后分支型室速经静滴异丙肾上腺素后诱发心动过速,且仍需静滴异丙肾上腺素后经心房食道调博终止心动过速,后经射频消融术成功根治。结论:TEAP及EECG可用于复杂心律失常的诊断及治疗,是一种相对安全、临床容易掌握的技术,值得推广。

Using of Transesophageal Atrial Pacing and Esophageal Electrocardiogram in Arrhythmia

Objective: To analyze the value of transesophageal atrial pacing(TEAP) and esophageal electrocardiogram(EECG) in arrhythmia. Methods: From June 2018 to December 2019, 189 patients with esophageal electrocardiogram and transesophageal pacing in our hospital were selected, including 80 males and 109 females, aged 11~83. Results: Within those 189 in patients, 54 patients are atrioventricular nodal reentrant tachycardia(AVNRT). 34 patients are atrioventricular reentrant tachycardia(AVRT). 8 patients are atrial tachycardia(AT). 4 patients are atrial flutter(AF). 6 patients were atrial fibrillation(Af). 5 patients were ventricular tachycardia(VT). The remaining 78 samples are premature ventricualr contraction or others. 105 patients with arrhythmia were treated with TEAP to terminate tachycardia. TEAP S1 S1 was successfully converted to sinus rhythm in all AVNRT and AVRT patients and 17 AT patients, 50 AVNRT and 32 AVRT and 6 AT and 3 AF and 2 VT patients were successfully cured by radiofrequency ablation. Among them, one patient aged11 AT turns into sinus rhythm by intravenous propafenone because She was unable to tolerate TEAP. 97 patients were induced by TEAP and 49 patients were induced tachycardia. One case of left posterior fascicular ventricular tachycardia induced tachycardia by intravenous isoproterenol, and still need intravenous isoproterenol after the atrial esophagus to stop tachycardia, after radiofrequency ablation successfully cured. Conclusions: TEAP and EECG can be used in the diagnosis and treatment of complex arrhythmia, which is a relatively safe and easy to master in clinic, and is worth popularizing.