Critelli G, Grassi G, Perticone F, Coltorti F, Monda V, Condorelli M
Am J Cardiol. 1983 Feb;51(3):513-8. doi: 10.1016/s0002-9149(83)80090-3.
An esophageal lead was used to perform decremental atrial pacing and elective induction of atrial fibrillation (AF) in 5 patients with the Wolff-Parkinson-White (W-P-W) syndrome before and after amiodarone therapy. In the control state, 1:1 atrioventricular (AV) conduction over the accessory pathway ranged from 220 to 260 ms (mean 232). The shortest R-R interval during AF ranged from 190 to 210 ms (mean 198). The ventricular rate ranged from 175 to 212 beats/min (mean 196). After amiodarone therapy, the shortest cycle length with 1:1 AV conduction increased in all patients, ranging from 290 to 540 ms (mean 370); during AF, no preexcited beat was present in 2 patients, whereas the minimal preexcited R-R interval in the remaining 3 was 290, 240, and 370 ms, respectively. The ventricular response during AF decreased in all patients. Thus, esophageal pacing is a useful method for identifying patients at risk with the W-P-W syndrome and for assessing appropriate management in individual patients. Amiodarone provides protection against life-threatening arrhythmias in these patients.
在5例预激综合征（W-P-W综合征）患者中，于胺碘酮治疗前后，使用食管导联进行递减性心房起搏及选择性心房颤动（AF）诱发。在对照状态下，经旁路的1:1房室（AV）传导时间为220至260毫秒（平均232毫秒）。AF期间最短的R-R间期为190至210毫秒（平均198毫秒）。心室率为175至212次/分钟（平均196次/分钟）。胺碘酮治疗后，所有患者中1:1 AV传导的最短周期长度均增加，范围为290至540毫秒（平均370毫秒）；在AF期间，2例患者无预激搏动，而其余3例患者的最小预激R-R间期分别为290、240和370毫秒。所有患者AF期间的心室反应均降低。因此，食管起搏是识别预激综合征高危患者及评估个体患者适当治疗的有用方法。胺碘酮为这些患者提供了预防危及生命心律失常的保护作用。
