Electrophysiological Parameters of Sinus Node Function in Patients with Paroxysmal Tachyarrhythmias

Abstract

to analyze the indicators of the function of the sinus node in patients of young age with paroxysmal tachycardia. Methods: study included 11 patients with suspected paroxysmal tachycardia, with an average age of 17±28. The basis for holding transesophageal electrophysiological study (TE EPS) was the clinical and electrophysiological characteristics of paroxysmal tachycardia. According to the results of Holter monitoring ECG (HM ECG) analyzed the minimum and maximum heart rate, number of ventricular and supraventricular arrhythmias, presence of pauses, rhythm and episodes of paroxysmal tachycardia. According to CHP, EFI estimated the initial heart rate (HR), recovery time of sinus node function (RTSNF), corrected recovery time of sinus node function (CRTSNF), point of Wenkebach (p. W), duration of the effective refractory period of the atrioventricular connections, presence of aberrant complexes and episodes of paroxysmal tachycardias before and after administration of atropine at a dose of 0.02 mg/kg. Results: Complaints characteristic of the tachyarrhythmia was diagnosed in 9 patients, episodes of heart rate more than 150 beats per minute in 7 patients. When conducting TE EPS obtained the following results: episodes of supraventricular tachycardia provoked in 8 patients (in two cases of paroxysmal tachycardia managed to provoke only after administration of atropine). Three of them have shimmer and atrial flutter episodes reciprocal tachycardia in five. Three patients provoke paroxysmal tachycardia failed, but they showed a shortening of the PQ interval and the appearance of aberrant QRS complexes when stimulated. In patients with paroxysmal SVT signs of sinus node dysfunction was detected in 6 patients, in the form of episodes of sinus arrhythmia (4 patients), migration pacemaker the atria (4 patients), sinoatrial blockade of II degree (3 patients), blockade of legs of bunch of gisa (2 patients), atrioventricular block degree II-III (1 patient), RTSNF more than 1500 MS in 1 patient, CRTSNF greater than 500 msec in 3 patients. Conclusion: in 6 of 9 patients with supraventricular paroxysmal tachycardia revealed signs of sinus node dysfunction, probably has a vagotonic in nature.

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