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e707004304
Wysłany: Pią 12:10, 11 Mar 2011
Temat postu: After surgery interval bypass pre-excitation syndr
,
tory burch reva
After surgery interval bypass pre-excitation syndrome and electrophysiological characteristics of epicardial positioning
BE ÷ LRA ÷ cs. HBE constant as the old VA 135ms, was V-A-H-V cross-shaped. Rv supraventricular tachycardia and pacing during the VA interval HBE constant t35ms. EPS defined as the interval of a right-free wall AP. EcM positioning. 36, t5'3 point. AP has been completed by the surgical cutting fishing base plate. Tin fell 1 1 2 cases of EPs recorded prince Yu 2] ~ EPS records fell 3 female, 30 years old. Onset of a supraventricular tachycardia, the permanent table for the A + B-type ECG. EPS test results (1) sinus rhythm, HBE V-crossing ahead, AH65ms. HV30msI (2) RA pacing,
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, AH65ms constant} (3) RV pacing, HBE and CSp of Ae simultaneously, and then spread to CSd ~ LRA, VA Lu of constant 110ms. EPS defined as PSAP'ECM positioning 36,45 points. Barrier has been completed by the surgical cutting rule] apply. Feeding 4 M, 45 years old. Repeated supraventricular tachycardia episodes 5 years, no improvement in drug therapy. Supraventricular tachycardia as heart rate select 250 beats / min, ORS normal morphology. When EcG quiet normal for the latent preexcitation. EPS Results: (1) attack of supraventricular tachycardia induced HBE of the Ae Ae occur simultaneously with the CSp; (2) RV pacing VA HBE's constant 130ms, when arrived Dash bundle refractory period and when the VA is still between the retrograde medullary of the constant. EPS defined as PSAP. ECM localization, induced supraventricular tachycardia episodes mapping atrial A4S, A36 point first. RV pacing, atrial mapping. After the interval Medical epicardial cross by Guo s-A most boats, cut by the end of IPSAP base Hao box. 28% reported in the literature discussed in the AP after the interval [ColavitaPG, et4I. Am】 Cardiot, l987, 59:601.3. After a short interval of complex anatomic area and the distribution of diversity, mapping and more difficult surgical procedure. PSAP success rate reported in the literature (88 ~ ~ / o) lower than the free wall AP success rate (9
, and 12 trapped surgery Cardiology 2O 1992 No. 4 lead to atrioventricular block. Therefore,
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, to ensure accurate positioning PSAP prerequisite for successful operation. PSAP 6 patients in this group were cured by surgery, with an average follow-up 9 months, no recurrence of supraventricular tachycardia and conduction block. Based on 6 patients with a preoperative examination, surgical technique and results of successful testing. The following tips can be used as electrophysiological characteristics of the diagnosis of PSAP based on: (1) conduction intervals prior to AP, HBE sinus rhythm leading V-wave, which is the interval before the conduction characteristics of AP. No concealed AP prequel or normal pre-excitation is manifested in the V intracardiac electrogram wave synchronization. (2) when atrial pacing at different frequencies,
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, AH does not vary with frequency, faster pacing and extended, and AH appear between relatively fixed. The AH interval between the AP of> 60ms, and this feature is relatively constant and dual atrioventricular node pathways, free wall AP and enhanced atrioventricular nodal conduction was significantly different. Dual atrioventricular node pathways in the AH interval shortened with the Ss arise between the jumps of the extension of free wall AP} The AH interval shortened with the emergence of ssz asked gradually extended; atrioventricular node conduction is enhanced when the AH ≤ sinus rhythm 60ms,
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, atrial pacing may be slightly longer, but when AH <100ms. (3) incremental ventricular pacing lead and HBE's Ae relatively constant VA interval, enter the bundle when the remains of the VA should not be retrograde. The retrograde atrial activation sequence with the normal identification of VA interval is normal to the Dash's in Cambodia should not be pacing rate of increase before the increase as fast and extended. (4) on the forward speed reentry ventricular septal Ae lead, and with similar cycle length of ventricular pacing VA interval the same. (5) retrograde atrial activation time, CSp almost simultaneously with the HBE of the Ae 6 patients in this group made the ECM PSAP has the following characteristics. (1) Pre-excitation point location on 36,45 points. Zoning Law by Gallagher53 point cross in the Department of the epicardium. (2) because of the excitement of the interval required by the AP some time to spread the epicardium, so the first excited single, bipolar Figure V crossing behind the surface ECG, △ crossing 10 ~ 20ms, pole V wave was rs type. (3) non-concealed preexcitation prior to the conduction, RV pacing retrograde atrial 45,36 points between the shortest s-A. (4) Atrial mapping t at room temperature, cut the right atrium after CPB in right ventricular stroke rapidly over the line after the interval scale guillotine, looking for the shortest s-A interval parts. Since we made only 6-side position PSAP observation function have not been observed when the Cambodian branch block changes in VA interval curve, characterized by further research permit to be cool. 'King of chaos in the kitchen to get Qiu startled. Hu hoe butterfly.
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