Guarnerio M, Furlanello F, Del Greco M, Vergara G, Inama G, Disertori M
Division of Cardiology, S. Chiara Hospital, Trento, Italy.
Am Heart J. 1989 Jun;117(6):1241-52. doi: 10.1016/0002-8703(89)90402-x.
Here we report on a study of 181 episodes of spontaneous atrial flutter (AF) (mean atrial cycle length 250 +/- 32 msec) treated by transesophageal atrial pacing (TAP) in 138 patients (92 men and 46 women; mean age 59.5 +/- 12.6 years). TAP was effective in 163 episodes (90%); sinus rhythm resumption was immediate in 36 (19.9%) and followed a short period of atrial fibrillation in 64 (35.3%); in 63 episodes (34.8%) a stable atrial fibrillation was obtained. TAP was unsuccessful in 18 cases (10%). All the patients tolerated the procedure well. A statistical elaboration with the Fisher exact test did not evidence a correlation between efficacy and age, sex, atrial cycle length, or underlying heart disease but showed a significant correlation between efficacy and AF duration of less than 1 day (p less than 0.05) and absence of antiarrhythmic pharmacologic pretreatment (p less than 0.01). These data strongly support the immediate first-choice use of TAP in AF therapy.
在此，我们报告一项针对138例患者（92例男性和46例女性；平均年龄59.5±12.6岁）的181次自发性心房扑动（AF）发作（平均心房周期长度250±32毫秒）进行经食管心房起搏（TAP）治疗的研究。TAP在163次发作中有效（90%）；36次（19.9%）立即恢复窦性心律，64次（35.3%）在短时间心房颤动后恢复窦性心律；63次发作（34.8%）获得稳定的心房颤动。18例（10%）患者TAP治疗失败。所有患者对该操作耐受性良好。采用Fisher精确检验进行统计学分析，未发现疗效与年龄、性别、心房周期长度或基础心脏病之间存在相关性，但显示疗效与AF持续时间小于1天（p<0.05）及未进行抗心律失常药物预处理（p<0.01）之间存在显著相关性。这些数据有力地支持了TAP作为AF治疗的首选即刻治疗方法。
