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窄QRS波心动过速时对心房超速起搏的反应。其机制是什么？

Response to atrial overdrive pacing during narrow QRS tachycardia. What is the mechanism?

作者信息

Majumdar Suchit, Mohanan Nair Krishna Kumar, Namboodiri Narayanan, Valaparambil Ajitkumar

机构信息

Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, 695011, India; Dept of Cardiology, Apollo Gleneagles Hospital, Calcutta, West Bengal, India.

Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, 695011, India.

出版信息

Indian Pacing Electrophysiol J. 2020 Sep-Oct;20(5):203-205. doi: 10.1016/j.ipej.2020.07.002. Epub 2020 Jul 28.

DOI:10.1016/j.ipej.2020.07.002
PMID:32730799
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7517583/
Abstract

A 35-year old lady with no pre-excitation on surface electrocardiogram underwent EP study for recurrent palpitation and documented adenosine responsive narrow QRS tachycardia. Regular narrow QRS tachycardia was induced with critical AH delay on programmed atrial stimulation. An atrial overdrive pacing (AOD) was performed during the tachycardia (Fig: 1 & 2). What is the response to AOD and what is the mechanism of tachycardia?

摘要

一名35岁女性，体表心电图无预激表现，因反复心悸接受电生理检查，记录到腺苷反应性窄QRS波心动过速。程控心房刺激时诱发规则的窄QRS波心动过速，伴有严重的AH间期延长。在心动过速发作时进行了心房超速起搏（AOD）（图1和图2）。AOD的反应是什么，心动过速的机制是什么？

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3ce/7517583/29935981b8c2/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3ce/7517583/e93333d92098/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3ce/7517583/29935981b8c2/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3ce/7517583/e93333d92098/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3ce/7517583/29935981b8c2/gr2.jpg

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本文引用的文献

1
Novel use of atrial overdrive pacing to rapidly differentiate junctional tachycardia from atrioventricular nodal reentrant tachycardia.心房超速起搏在快速鉴别交界性心动过速与房室结折返性心动过速中的新应用。
Heart Rhythm. 2011 Jun;8(6):840-4. doi: 10.1016/j.hrthm.2011.01.011. Epub 2011 Jan 7.
2
The response of paroxysmal supraventricular tachycardia to overdrive atrial and ventricular pacing: can it help determine the tachycardia mechanism?阵发性室上性心动过速对超速心房和心室起搏的反应：它能否有助于确定心动过速机制？
J Cardiovasc Electrophysiol. 1993 Jun;4(3):239-52. doi: 10.1111/j.1540-8167.1993.tb01227.x.