アトリウヴェントリキュラーノードル再入口. 臨床的,電気生理学的,治療的考慮事項
M Akhtar1, M R Jazayeri, J Sra
1Sinai Samaritan Medical Center, Milwaukee, Wis. 53233.
Circulation
|July 1, 1993
まとめ
低心拍の一般的な原因である心房中枢 (AV) のノードル再侵入は,放射線周波数カテーテル切除で効果的に治療されます. 緩やかな経路の切除は,高い成功率と AV ブロックの低いリスクのために好ましい.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 心律不整症とは,心律不整症のこと.
背景:
- 心房中枢 (AV) の結節再侵入は,定期的な,狭いQRS短心症の頻繁な原因です.
- アリズム障害は,AVノード領域内の二重伝導経路に起因する.
- 共通 (遅い前行,速い後退) と非共通 (逆行) の2つの形態が存在します.
研究 の 目的:
- AVノードル再侵入の臨床,心電図 (ECG),および電気生理学的特徴について議論します.
- この心拍不全の管理のための現在のおよび新興の治療アプローチをレビューする.
主な方法:
- 診断は,P波の特徴を注意して,表面EKGの解釈によって助けられます.
- 心臓内電気生理学的評価は,正確な診断を提供します.
- 治療方法には,薬剤療法とカテーテル除去が含まれます.
主要な成果:
- 一般的な形は,遮蔽されたまたは終端のP波を示し,珍しい形は,長いRP間隔を示します.
- アデノシンは急性終結に有効です.
- 医薬品 (ベータブロッカー,カルシウムチャネルブロッカー,抗不律薬) は,再発の予防に役立ちます.
- 急速または遅い経路の放射線周波数カテーテル切除は,治癒的治療を提供します.
- 遅い経路アブレーションは,高速経路アブレーションと比較して,より高い成功率とより低いAVブロックリスクを示しています.
結論:
- AVノードル再侵入は,電気生理学で診断される一般的なパラキシズマル・スプラベントリキュラ・タヒカルディアです.
- 抗リズム薬は効果的ですが,放射性カテーテル切除は有望な治癒療法です.
- AVノードのカテーテル改変が,症状のある症例の好ましい初期治療法として浮上しています.
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