Gallagher J J, Smith W M, Kasell J, Smith W M, Grant A O, Benson D W
Pacing Clin Electrophysiol. 1980 Jul;3(4):440-51. doi: 10.1111/j.1540-8159.1980.tb05253.x.
Recent studies have emphasized the role of concealed accessory pathways in reciprocating supraventricular tachycardia. Diagnosis has generally required multicatheter electrophysiologic study. We recorded esophageal electrograms during study in 16 patients with reciprocating tachycardia due to reentry using an accessory atrioventricular pathway, and in 12 patients with reciprocating tachycardia due to reentry in the AV node. The interval from onset of ventricular depolarization to earliest atrial activation (V-AMIN), earliest atrial activity on the esophageal lead (V-AESO), and high right atrium (V-HRA) was measured. No patient with RT due to an accessory atrioventricular pathway had a V-AMIN or V-AESO less than 70 ms, or a V-HRA less than 95 ms. In contrast, 11 of 12 patients with reentry in the AV node had V-AESO intervals less than 70 ms. Esophageal recording during reciprocating tachycardia provides a simple screening procedure available to all practicing physicians to exclude the diagnosis of accessory atrioventricular pathways in the genesis of paroxysmal supraventricular tachycardia.
近期研究强调了隐匿性旁路在房室折返性室上性心动过速中的作用。诊断通常需要多导管电生理检查。我们在研究期间记录了16例因房室旁路折返导致折返性心动过速患者和12例因房室结折返导致折返性心动过速患者的食管心电图。测量了从心室去极化开始到最早心房激动（V-AMIN）、食管导联最早心房活动（V-AESO）以及高位右心房（V-HRA）的间期。因房室旁路导致折返性心动过速的患者中，无一例V-AMIN或V-AESO小于70毫秒，或V-HRA小于95毫秒。相比之下，12例因房室结折返的患者中有11例V-AESO间期小于70毫秒。折返性心动过速期间的食管记录为所有执业医师提供了一种简单的筛查方法，以排除阵发性室上性心动过速起源中房室旁路的诊断。
