Pittman D E, Gay T C
Angiology. 1977 Sep;28(9):599-613. doi: 10.1177/000331977702800904.
Many tachyarrhythmias present difficult diagnostic problems. In patients with underlying cardiac disease, serious hemodynamic derangements can be the sequelae of uncontrolled or improperly treated arrhythmias. Our experience, illustrated by the case presentations, confirm that intraatrial electrocardiography is a safe and reliable technique for elaborating difficult tachyarrhythmias that are not conclusively diagnosed by noninvasive ECG techniques. Because misinterpretation of tachycardias can lead to incorrect therapeutic decisions, the minimal risk of such a procedure is far surpassed by the information obtained, which allows for correct diagnosis and aids in guiding effective therapy. Although careful, critical analysis of ECG and rhythm strips frequently allows a proper diagnosis, occasions often arise when the rhythm cannot be accurately defined. In such instances an intraatrial lead electrocardiogram can be utilized and is invariably of diagnostic aid in resolving the relationship of the P wave to the QRS complexes, which is usually the important key to a tachyarrhythmia diagnosis.
许多快速性心律失常存在诊断难题。对于有基础心脏病的患者，严重的血流动力学紊乱可能是心律失常未得到控制或治疗不当的后果。我们从病例报告中得到的经验证实，心房内心电图是一种安全可靠的技术，可用于阐明无创心电图技术无法确诊的复杂快速性心律失常。由于对快速性心律失常的错误解读可能导致错误的治疗决策，该检查方法的最小风险远远低于所获得的信息价值，这些信息有助于正确诊断并指导有效治疗。虽然仔细、批判性地分析心电图和心律条图通常能得出正确诊断，但仍常有无法准确界定心律的情况出现。在这种情况下，可采用心房内导联心电图，它对于解析P波与QRS波群的关系总是有诊断帮助，而这通常是快速性心律失常诊断的关键。
