Murphy P, O'Keeffe D B
Cardiac Unit, Belfast City Hospital, Ireland.
Pacing Clin Electrophysiol. 1991 Mar;14(3):404-9. doi: 10.1111/j.1540-8159.1991.tb04087.x.
In order to assess whether atrial pacing reduced the frequency of tachycardia in patients with recurrent junctional tachycardias, ten patients with recurrent junctional tachycardias with atrial Intertach antitachycardia pacemakers in situ were paced in a random order in atrial demand mode at 50 ppm (AAI 50), 80 ppm (AAI 80), and 100 ppm (AAI 100) for a period of up to 1 month. The numbers of tachycardias detected by the pacemaker over this period were recorded and compared with the number seen when unpaced (000). Correct arrhythmia detection by the pacemaker was confirmed by Holter monitoring. The number of tachycardias in 000 was 44.7 +/- 19.8 (mean +/- SEM). No significant reduction in tachycardia frequency was seen in any pacing mode. Back-up atrial pacing at 50 ppm tended to reduce the frequency of tachycardias (32.3 +/- 12.8 tachycardias; P = 0.06). The higher pacing rates increased the number of tachycardias (AAI 80; 57.1 +/- 24.6 tachycardias, P = 0.20: AAI 100; 81.8 +/- 30.2 tachycardias; P = 0.31). Symptoms increased with each pacing mode and palpitations were statistically more severe in AAI 100 mode. Four patients had disabling symptoms at this rate and had to drop out. Atrial back-up pacing may be of use in some patients with junctional tachycardia, but overdrive pacing is not helpful.
为了评估心房起搏是否能降低反复发生交界性心动过速患者的心动过速频率，对10例植入心房抗心动过速起搏器且反复发生交界性心动过速的患者，以随机顺序在心房按需模式下分别以50次/分钟（AAI 50）、80次/分钟（AAI 80）和100次/分钟（AAI 100）进行起搏，持续时间最长为1个月。记录该时间段内心脏起搏器检测到的心动过速次数，并与未起搏时（000）的次数进行比较。通过动态心电图监测确认起搏器对心律失常的正确检测。000时的心动过速次数为44.7±19.8（平均值±标准误）。在任何起搏模式下均未观察到心动过速频率有显著降低。50次/分钟的备用心房起搏倾向于降低心动过速频率（32.3±12.8次心动过速；P = 0.06）。较高的起搏频率增加了心动过速次数（AAI 80；57.1±24.6次心动过速，P = 0.20；AAI 100；81.8±30.2次心动过速；P = 0.31）。每种起搏模式下症状均加重，在AAI 100模式下心悸在统计学上更严重。4例患者在此频率下出现致残症状，不得不退出。心房备用起搏可能对一些交界性心动过速患者有用，但超速起搏并无帮助。
