Why the study?
Does ventricular extrastimulus testing during basic ventricular and atrial simultaneous pacing improve the analysis of V-A conduction and induction of uncommon AVNRT in a patient where routine EPS failed?
Does ventricular extrastimulus testing during basic ventricular and atrial simultaneous pacing improve the analysis of V-A conduction and induction of uncommon AVNRT in a patient where routine EPS failed?
Ventricular extrastimulus testing during simultaneous ventricular and atrial pacing is a useful maneuver for analyzing and inducing uncommon AVNRT with a long retrograde conduction pathway when routine EPS fails.
May facilitate uncommon AVNRT induction after failed routine EPS; hypothesis-generating for adoption in electrophysiology protocols.
64歳, 女性.10年前より1分から1時間持続する動悸を自覚.1993年6月, 5時間以上動悸が持続し, 近医受診.稀有型房室結節リエントリー性頻拍症 (以下uncommon AVNRT) を疑われ, 精査目的にて当科入院となった.頻拍時心電図は心拍数125拍/分, Narrow QRS, Long RP'であった.通常の電気生理学的検査では房室結節の二重伝導路は証明できず, また再現性をもって室房伝導を確認できなかった.室房伝導の解析, 頻拍誘発を目的に室房同時ペーシング下心室早期刺激法を施行した.同方法にて伝導時間の長い (420～640msec) 室房伝導が確認され, 再現性をもってuncommon AVNRTの誘発が可能であった.伝導時間の長い逆伝導路を有するuncommon AVNRTの解析に室房同時ペーシング下心室早期刺激法が有用であったので報告する.
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Umetani et al. (1995) studied this question.
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