Grolleau R, Carabasse D, Leclercq F
Service de cardiologie, hôpital Arnaud-de-Villeneuve, Montpellier.
Arch Mal Coeur Vaiss. 1995 Jan;88 Spec No 1:41-51.
The atrioventricular junction consists of the atrioventricular node and the bundle of His up to its division. All tachycardias arising in these structures or which depend on these structures for their sustenance are called "junctional". There are four main types. The first three correspond to reciprocating rhythms, nodal tachycardia, tachycardias using an accessory pathway with unidirectional retrograde conduction, and chronic reciprocating atrioventricular nodal tachycardia. All varieties of reciprocating atrioventricular nodal tachycardia have been well studied and their diagnosis is possible from the standard surface electrocardiogram from the position and morphology of the P' wave. They are accessible to radical treatment by radiofrequency ablation of the slow pathway or accessory pathway, when present. The definitive treatment of ectopic atrioventricular nodal tachycardia is not yet established and has to be considered case by case, this form of arrhythmia being rare.
房室交界区由房室结和希氏束直至其分支组成。起源于这些结构或依赖这些结构维持的所有心动过速都称为“交界性”。主要有四种类型。前三种分别对应折返性节律、房室结性心动过速、使用具有单向逆向传导的旁路的心动过速以及慢性折返性房室结性心动过速。各种类型的折返性房室结性心动过速都已得到充分研究，根据P'波的位置和形态，从标准体表心电图即可做出诊断。当存在慢径路或旁路时，可通过射频消融慢径路或旁路进行根治性治疗。异位性房室结性心动过速的确定性治疗方法尚未确立，必须逐案考虑，因为这种心律失常形式较为罕见。
