Conflicting responses with simultaneous atrioventricular pacing. What is the mechanism?

Q3 Medicine Indian Pacing and Electrophysiology Journal Pub Date : 2024-11-01 Epub Date: 2024-08-22 DOI:10.1016/j.ipej.2024.08.004
Suresh Kumar Sukumaran, Anish Bhargav, Sridhar Balaguru, Raja J Selvaraj
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房室同步起搏时的冲突反应。其机制是什么?
一名 60 岁的女性反复发作心悸,记录有短 RP、窄 QRS 心动过速,窦性心律时心电图无预激。在电生理学检查中,程序性刺激诱发了窄 QRS 心动过速,周期长度为 380 毫秒,VA 间期为 164 毫秒,最早的心房激活位于 His 区。即使输注异丙肾上腺素,心室超速起搏也不能控制心房,而心房猝发起搏多次终止了心动过速。起搏与 SVT 的 AH 间期相差 27 毫秒。同时进行心房和心室起搏,并从右心房高点进行心房起搏,结果显示第一个回波电图为 His 信号,提示房室结复律性心动过速(AVNRT)(图 1)。从冠状窦近端进行心房起搏后重复该操作,显示心房信号为第一个回流电图,提示房性心动过速(AT)(图 2)。两种起搏操作的结果相互矛盾,原因何在?
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来源期刊
Indian Pacing and Electrophysiology Journal
Indian Pacing and Electrophysiology Journal Medicine-Cardiology and Cardiovascular Medicine
CiteScore
2.20
自引率
0.00%
发文量
91
审稿时长
61 days
期刊介绍: Indian Pacing and Electrophysiology Journal is a peer reviewed online journal devoted to cardiac pacing and electrophysiology. Editorial Advisory Board includes eminent personalities in the field of cardiac pacing and electrophysiology from Asia, Australia, Europe and North America.
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