经食管心房起搏治疗妊娠期阵发性室上性心动过速

Chaoyang Sun, Y. Hou, Deqi Yan, Shifeng Li, Zhong-jian Li
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摘要

目的探讨经食管心房起搏抑制和终止妊娠阵发性室上性心动过速(PSVT)的临床疗效和安全性。方法选取2004年5月至2018年12月郑州大学第二附属医院收治的31例PSVT孕妇为研究对象。所有患者均以比PSVT快30-50次/分钟的频率S1S1刺激2-5次,初始电压为20 V。如果PSVT不能停止,可以适当增加刺激频率、刺激次数和输出电压,重复S1S1刺激。若以上方法均无效,可采用RS2刺激终止PSVT。结果所有患者均经食管心房起搏终止PSVT。其中S1S1刺激后终止28例,RS2刺激后终止3例。临床治愈率100%。治疗过程中未见不良反应,胎儿心率未受影响。结论经食管房性心动过速是一种安全、快速、可重复终止妊娠期PSVT的方法。关键词:妊娠;食管心房起搏;阵发性室上性心动过速
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Transesophageal atrial pacing in the treatment of paroxysmal supraventricular tachycardia in pregnancy
Objective To study the clinical efficacy and safety of transesophageal atrial pacing in the suppression and termination of paroxysmal supraventricular tachycardia (PSVT) in pregnancy. Methods Thirty-one pregnant women with PSVT treated in the Second Affiliated Hospital of Zhengzhou University from May 2004 to December 2018 were selected as research objects. All patients were stimulated by S1S1 for 2-5 times at a frequency of 30-50 times/minute faster than PSVT, and the initial voltage was 20 V. If the PSVT could not be stopped, the stimulation frequency, number of stimulation and output voltage could be increased properly for repeated S1S1 stimulation. If above methods could not work, RS2 stimulation should be used to terminate PSVT. Results PSVT in all patients were terminated by transesophageal atrial pacing. Of them, 28 cases were terminated after the stimulation of S1S1, and 3 cases were terminated after the stimulation of RS2, additionally. The clinical recovery rate was 100%. There was no adverse reaction in the treatment, and the heart rates of fetus were not affected. Conclusions Transesophageal atrial tachycardia is a safe, rapid and repeatable method for termination of PSVT in pregnancy. Key words: Pregnancy; Esophageal atrial pacing; Paroxysmal supraventricular tachycardia
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