Nozaki A, Matsuo H, Inoue H, Sugimoto T
Jpn Circ J. 1986 Jan;50(1):91-8. doi: 10.1253/jcj.50.91.
In order to study the entrainment phenomenon in various forms of clinical and experimental tachycardia, overdrive pacing was performed in clinical paroxysmal supraventricular tachycardia (PSVT) of Wolff-Parkinson-White syndrome (6 cases), atrial flutter (AF-6 cases), ventricular tachycardia (VT-2 cases), experimental AF induced by Rosenblueth's method (5 dogs), and in VT induced by aconitine (5 dogs). Progressive fusion was demonstrated in all but aconitine-induced VT. After cessation of pacing, the first tachycardia complex showed no fusion at all, but the timing of the complex varied depending on the recording sites of the electrogram. The tachycardia complex occurred at the pacing rate only when the electrogram was recorded at the upstream of the pacing site along the reentry circuit in PSVT and experimental AF. In clinical VT, the complex appeared progressively later as the pacing rate was increased. In aconitine-induced experimental VT, the complex occurred at its original tachycardia rate originating from the site where aconitine was applied. In reentrant tachycardia, entrainment could be observed even when all three of the diagnostic criteria proposed by Brugada et al. were not fulfilled. The mechanism of tachycardia can be assessed by entrainment, although the proposed criteria should be reevaluated.
为研究各种临床和实验性心动过速中的拖带现象，对6例预激综合征（Wolff-Parkinson-White syndrome）的临床阵发性室上性心动过速（PSVT）、6例心房扑动（AF）、2例室性心动过速（VT）、采用Rosenblueth法诱发实验性AF的5只犬以及用乌头碱诱发VT的5只犬进行了超速起搏。除乌头碱诱发的VT外，所有情况均显示出进行性融合。起搏停止后，第一个心动过速复合波完全没有融合，但复合波的时间根据心电图记录部位而有所不同。仅当在PSVT和实验性AF中沿折返环在起搏部位上游记录心电图时，心动过速复合波才以起搏频率出现。在临床VT中，随着起搏频率增加，复合波出现得越来越晚。在乌头碱诱发的实验性VT中，复合波以其源于应用乌头碱部位的原始心动过速频率出现。在折返性心动过速中，即使不满足Brugada等人提出的所有三项诊断标准，也可观察到拖带现象。尽管所提出的标准应重新评估，但拖带现象可用于评估心动过速的机制。
