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[心房电刺激的临床应用]

[Clinical use of electrical atrial stimulation].

作者信息

Tsenov I, Urumov G

出版信息

Vutr Boles. 1979;18(4):59-69.

PMID:494634
Abstract

Electric auricle stimulation (EAS) was realized in a total of 77 patients. In 60 of the patients EAS was performed as a hypoxic test (step-wise increase of heart rate, with ECG registration and in many of the cases -- registration of certain indices of general and intracardial hemodynamics) with a view to precise diagnosis of ischemic heart disease and assessment of myocardial contraction function. In 91 per cent of the patients with stenosed coronary pathology on coronarogram, the symptoms of coronary insufficiency were positive (pain attack, ECG changes via ischemic type and/or deterioration of the myocardial functional curve) with the aid of EAS. Various correlations were established between the manifestations of coronary insufficiency and the deterioration of the functional curve of left ventricle. Furthermore, in the majority of the cases, one way results, among the data of veloergometry, coronarography and EAS, were recorded. In some cases EAS provided additional data for coronary insufficiency with negative veloergometric test (7 patients) and negative coronarography (5 patients). EAS could be applied in the diagnostics of ischemic heart disease, and in a hemodynamic aspect, via EAS a myocardial loading is realized with a minimum change of cardiac index and aortic pressure. In 16 patients EAS was applied with a view to the investigation of the functional state of sinal node and heart conduction system. In 13 patients, data about the syndrome of morbid sinal node were found (pathologic time of sinal node restoration) or for a latent lesion of heart conduction system. In the other three patients the suspicion of syndrome of morbid sinal node was not confirmed. The data obtained contributed to the determination of the therapeutic approach of those patients. In 5 patients a high frequency auricle electrostimulation was applied successfully in the interruption of paroxysms of supraventricular tachycardia. EAS was concluded, on the base of the data obtained, to be appropraite for application and precise diagnosis of ischemic heart disease, as well as in the studies on sinal node state and heart conduction system. In some rhythm disturbances, resistant to medicamentosus treatment, the electric auricle stimulation could prove a valuable therapeutic method.

摘要

共有77例患者接受了电耳刺激(EAS)。其中60例患者进行EAS作为低氧试验(心率逐步增加,同时记录心电图,在许多情况下还记录全身和心内血流动力学的某些指标),旨在精确诊断缺血性心脏病并评估心肌收缩功能。在冠状动脉造影显示冠状动脉病变狭窄的患者中,91%的患者借助EAS出现冠状动脉供血不足症状阳性(疼痛发作、心电图出现缺血型改变和/或心肌功能曲线恶化)。冠状动脉供血不足的表现与左心室功能曲线恶化之间建立了各种相关性。此外,在大多数情况下,在运动负荷试验、冠状动脉造影和EAS的数据中记录到单向结果。在某些情况下,EAS为运动负荷试验阴性(7例患者)和冠状动脉造影阴性(5例患者)的冠状动脉供血不足提供了额外数据。EAS可应用于缺血性心脏病的诊断,从血流动力学角度来看,通过EAS可实现心肌负荷,而心脏指数和主动脉压变化最小。16例患者接受EAS以研究窦房结和心脏传导系统的功能状态。13例患者发现病态窦房结综合征数据(窦房结恢复的病理时间)或心脏传导系统潜在病变。另外3例患者未证实病态窦房结综合征的怀疑。所获得的数据有助于确定这些患者的治疗方法。5例患者成功应用高频耳电刺激终止室上性心动过速发作。根据所获得的数据得出结论,EAS适用于缺血性心脏病的应用和精确诊断,以及窦房结状态和心脏传导系统的研究。在一些药物治疗无效的心律失常中,电耳刺激可能是一种有价值的治疗方法。

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