Rosettani E, Giustetto C, Gaita F, Mangiardi L, Riccardi R, Brusca A
Istituto di Medicina e Chirurgia Cardiovascolare, Università di Torino.
G Ital Cardiol. 1987 Jul;17(7):569-74.
It is well known that in patients with Wolff-Parkinson-White (W.P.W.) adrenergic activity stimulation induced by exercise or isoproterenol I.V. infusion shortens the anterograde effective refractory period (E.R.P.) of the accessory pathway. Our purpose was to evaluate whether the upright position produces similar changes on the electrophysiologic properties of the accessory pathway and influences reciprocating tachycardias induction. In 18 patients, with W.P.W. syndrome, who underwent electrophysiologic study, we determined the anterograde E.R.P. of the accessory pathway and attempted to induce a reciprocating tachycardia in the supine and in the upright position. In 13 patients (72%) the anterograde E.R.P. of the accessory pathway shortened in the upright position (303 +/- 104 msec vs 331 +/- 123 msec; p less than 0.001); in 4 patients (22%) it was unchanged; in 1 patient was not defined, being inferior to the atrium E.R.P. We were able to induce a reciprocating tachycardia in 3 patients in the supine position, in 6 patients in the upright position. Electrophysiologic testing in the upright position improves the evaluation of the accessory pathway electrophysiologic properties.
众所周知，在预激综合征（W.P.W.）患者中，运动或静脉输注异丙肾上腺素所诱发的肾上腺素能活性刺激会缩短旁路的前向有效不应期（E.R.P.）。我们的目的是评估直立位是否会对旁路的电生理特性产生类似变化，并影响折返性心动过速的诱发。在18例接受电生理研究的预激综合征患者中，我们测定了旁路的前向E.R.P.，并试图在仰卧位和直立位诱发折返性心动过速。13例患者（72%）在直立位时旁路的前向E.R.P.缩短（303±104毫秒对331±123毫秒；p<0.001）；4例患者（22%）无变化；1例未明确，因其低于心房E.R.P.。我们在3例仰卧位患者和6例直立位患者中成功诱发了折返性心动过速。直立位进行电生理检查可改善对旁路电生理特性的评估。
