采用低输出、短持续时间经食管心房起搏将心房扑动直接转复为窦性心律。

Direct conversion of atrial flutter to sinus rhythm with low-output, short-duration transesophageal atrial pacing.

作者信息

Ajisaka H, Hiraki T, Ikeda H, Kubara I, Yoshida T, Ohga M, Imaizumi T

机构信息

Third Department of Internal Medicine, Kurume University School of Medicine, Japan.

出版信息

Clin Cardiol. 1997 Sep;20(9):762-6. doi: 10.1002/clc.4960200910.

DOI:10.1002/clc.4960200910

PMID:9294667

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6656004/

Abstract

BACKGROUND AND HYPOTHESIS

Transesophageal atrial pacing (TAP) is useful for terminating paroxysmal non-self terminating atrial flutter (PAF); however, high output pacing of long stimulus duration causes severe symptoms such as chest pain. The objective of this study was to investigate the effect of low-output, short-duration TAP on the conversion of PAF.

METHODS

We applied low-output (within 15 mA with a pulse duration of 10 ms), short-duration (within 4 s) TAP in 31 patients (50 +/- 19 years) with PAF. Transesophageal pacing was delivered with 10 pulses of burst pacing at intervals that were 20 ms shorter than those of the flutter wave length. When the conversion was unsuccessful, we delivered 20 pulses of burst pacing.

RESULTS

Sixteen patients (52%) were converted directly to sinus rhythm and 12 (38%) to atrial fibrillation. Transesophageal pacing was ineffective in 3 (10%) patients. The duration of atrial flutter, maximum flutter wave amplitude, effective pacing intervals, underlying heart diseases, and cardiac function were not different between patients who had direct conversion to sinus rhythm and those converted to atrial fibrillation. The patients who had direct conversion to sinus rhythm had longer flutter wave cycle lengths than those converted to atrial fibrillation (248 vs. 221 ms, p < 0.005). No patient had complications and complained of any symptoms.

CONCLUSION

Low-output, short-duration TAP was useful to convert PAF directly to sinus rhythm without side effects.

摘要

背景与假设

经食管心房起搏（TAP）可用于终止阵发性非自限性心房扑动（PAF）；然而，高输出、长刺激持续时间的起搏会引起胸痛等严重症状。本研究的目的是探讨低输出、短持续时间的经食管心房起搏对PAF转复的影响。

方法

我们对31例（50±19岁）PAF患者应用低输出（15 mA以内，脉冲持续时间为10 ms）、短持续时间（4 s以内）的经食管心房起搏。经食管起搏以比心房扑动波长短20 ms的间隔进行10次猝发起搏。如果转复未成功，则进行20次猝发起搏。

结果

16例患者（52%）直接转复为窦性心律，12例（38%）转复为心房颤动。3例（10%）患者经食管起搏无效。直接转复为窦性心律的患者与转复为心房颤动的患者在心房扑动持续时间、最大扑动波振幅、有效起搏间隔、基础心脏病及心功能方面无差异。直接转复为窦性心律的患者的扑动波周期长度比转复为心房颤动的患者长（248 vs. 221 ms，p<0.005）。无患者出现并发症或主诉任何症状。