房室折返性心动过速(AVRT)

关于这种常见的SVT形式,你应该知道些什么

医生协助的老年妇女

Juanmonino/Getty图片

People who experience sudden episodes oftachycardia(rapid heart rates),often have one of the many varieties of室上性心动过速(SVT).The term "SVT" encompasses a large variety ofcardiac arrhythmias这通常是突然开始和停止的,几乎总是不会危及生命,but that can be significantly disruptive to your life.

Atrioventricular reentrant tachycardia (AVRT) is the second most common type of SVT,accounting for about 30% of all SVTs.

AVRT是什么?

AVRT is a type of折返性心动过速.和所有可重入SVT一样,people with AVRT are born with an abnormal electrical connection in the heart.在AVRT,额外的连接,which is often called an "accessory pathway," creates an electrical connection between one of the atria (the upper chambers of the heart),其中一个心室(下部心腔).

通常情况下,the only电气连接在心房和心室之间是正常的心脏传导系统,which consists of theAV node还有他的包裹。

So,in people with AVRT,the accessory pathway provides a second electrical connection between the atria and the ventricles.第二个连接建立了一个建立折返性心动过速的潜在电路。

How Does AVRT Work?

在一个有附属通路的人身上,an episode of AVRT can be triggered by a premature heartbeat,either a房性早搏或Apremature ventricular contraction (PVC).

这个早搏,如果它发生在正确的时间,可触发连续(或可重入)电脉冲。这个脉冲沿着正常的传导系统传到心室,then travels back up the accessory pathway to the atria (that is,它“重新进入”心房,然后掉头回到正常的传导系统,等等。

因此,单次早搏会引起突然的心动过速。

The symptoms of AVRT are typical for SVT.它们通常包括palpitationslightheadedness,and/or头晕.剧集通常持续几分钟到几个小时。

如何停止AVRT?

AVRT can be stopped by a PAC,聚氯乙烯,或者仅仅通过房室结减慢传导。任何这些事件都可以中断可重入脉冲。

事实上,减慢房室结传导可以阻止房室结,这给了一个心律失常的人一个机会,使它消失。This opportunity takes advantage of the fact that the AV node is richly supplied by thevagus nerve.So,患有AVRT的人通常可以通过采取行动来增加迷走神经的张力来停止急性发作。This can be accomplished,例如,通过执行Valsalva maneuver,或者把你的脸浸入冰水中几秒钟。(The Valsalva maneuver is quicker,更方便,比冰水里的脸不那么难看。)

阿夫特与沃尔夫-帕金森-怀特综合征

在一些患有AVRT的人中,the accessory pathway is capable of conducting electrical impulses in either direction (that is,from the atrium to the ventricle as already described,or from the ventricle to the atrium).In other people,辅助通路只能在一个方向或另一个方向上传导电脉冲。

结果证明,这种差异很重要。在大多数患有AVRT的人中,脉冲只能穿过从心室到心房的辅助通路。

When the impulses are able to cross in the other direction — from the atrium to the ventricle —Wolff-Parkinson-White(WPW)综合征is said to be present.WPW is associated with clinical problems that go beyond "just" AVRT,通常需要更积极地对待。

Treating AVRT

If WPW is not present and symptoms of AVRT are rare and easily stopped (say,by performing a Valsavla maneuver),然后,除了学习当一个事件发生时该怎么做外,通常不需要任何治疗。However,如果你有WPW,frequent episodes of SVT,尤其是发作期间的严重症状,或者在事件发生时无法停止,然后应该使用更明确的治疗方法。

Antiarrhythmic drug therapyis often only partially effective at preventing episodes of AVRT.However,在大多数患有AVRT的人中,ablation therapyis able to get rid of the accessory pathway altogether,完全阻止任何进一步的事件。用现代技术,ablating accessory pathways can be accomplished successfully and safely in the vast majority of cases.

韦里韦尔的一句话必威下载

房室折返性心动过速(AVRT)是SVT的常见类型。虽然它经常会产生明显的症状,并对生活造成很大的破坏,AVRT today is very treatable.

这页有用吗?
Article Sources
  • 百灵杆菌B,Pauriah MSellal JM,et al.Incidence and Prognostic Significance of Spontaneous and Inducible Antidromic Tachycardia.Europace 2013;15:871.
  • Chugh AMorady F.房室折返和变种。在:从细胞到床边的心脏电生理学,5th Edition, Zipes DP,杰利夫J(EDS)Saunders/Elsevier,费城2009年。p.605-614.