人类的窦房结折返性心动过速。

Sinus node re-entrant tachycardia in man.

作者信息

Weisfogel G M, Batsford W P, Paulay K L, Josephson M E, Ogunkelu J B, Akhtar M, Seides S F, Damato A N

出版信息

Am Heart J. 1975 Sep;90(3):295-304. doi: 10.1016/0002-8703(75)90316-6.

Abstract

Sinus node re-entry (SNR) usually appears as a single beat. Tachycardias (SNRT) consistent with sustained SNR were seen in six patients and were initiated by premature stimulation of the high right atrium (six patients) and coronary sinus (four patients), and after continuous pacing from the high right atrium (four patients) or right ventricle (one patient) at rates of 130 to 200 per minute. During SNRT: (1) atrial beats exhibited a high-to-low atrial activation sequence, (2) the P-waves were similar in morphology to P-waves during sinus rhythm, and (3) re-entry in the A-V node or at the site of stimulation could be excluded. The cycle length of SNRT ranged from 625 to 320 msec. and SNRT either terminated spontaneously (six patients) or after premature atrial capture and/or vagal maneuvers (two patients). The electrophysiologic characteristics of SNRT and differentiation of SNRT from A-V nodal re-entry are discussed.

摘要

窦房结折返（SNR）通常表现为单个搏动。6例患者出现了与持续性SNR一致的心动过速（SNRT），其由高位右心房（6例患者）和冠状窦（4例患者）的过早刺激引发，以及在以每分钟130至200次的频率从高位右心房（4例患者）或右心室（1例患者）持续起搏后引发。在SNRT期间：（1）心房搏动呈现从高到低的心房激动顺序，（2）P波形态与窦性心律时的P波相似，并且（3）可排除房室结或刺激部位的折返。SNRT的周期长度范围为625至320毫秒。SNRT要么自发终止（6例患者），要么在过早心房夺获和/或迷走神经操作后终止（2例患者）。讨论了SNRT的电生理特征以及SNRT与房室结折返的鉴别。