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題名 | 陣發性上心室頻脈=Paroxysmal Supraventricular Tachycardia |
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作者 | 賴凌平; | 書刊名 | 中華民國急救加護醫學會雜誌 |
卷期 | 10:4 1999.12[民88.12] |
頁次 | 頁139-143 |
分類號 | 415.318 |
關鍵詞 | 陣發性上心室頻脈; 經導管電氣燒灼術; Paroxysmal supraventricular tachycardia; PSVT; Radiofrequency catheter ablation; |
語文 | 中文(Chinese) |
中文摘要 | 陣發性上心室頻脈(paroxysmal supraventricular tachycardia,簡稱PSVT)為急症中常見之診斷,病患最常見之症狀為突然發生之心悸,常伴隨其他全身性之症狀,包括頭暈,全身無力,盜汗,呼吸困難,胸悶等。 心電圖典型之表現為快速但規則之 QRS 波,其速度約在每分鐘一百五十到五十次之間。陣發性上心室頻脈最常見的機轉為房室結迴路頻脈(atrioventricularnodal reentrant tachycardia) 及房室往復式頻脈(atrioventricular reciprocating tachycardia) tachycardia),這兩者佔了 90% 以上, 其他還有心房頻脈 (atrial tachycardia) 心房樸動 (atrial flutter),但是較為少見。在急性處置上,對於血行動不穩定的病人可以考慮電擊,一般建議之電擊能量為 50 ∼100焦爾對於穩定的病人,我們建議先標準十二導程心電圖,再替病人圖,再替病人裝上心電圖監視器,然後實施頸動脈竇按摩(carotid massage)。 如果頸動脈竇按摩無效, 則可考慮藥物治療, 目前首選之藥物應為adenosine, 其他藥物如 verapamil,ditezam 之靜脈注身寸也常用來治療陣發性上心室頻脈。近年來對陣發上心室頻脈的治療上有突破性進展,經導管電氣燒灼術可以消滅心臟中之迴路,而使發性上心室頻脈得到根治,終生不再復發,而由於經導電氣燒灼術的進展,也使我們對陣發性上心室頻脈的電生理棧轉有更進一步的了解。 |
英文摘要 | Paroxysmal supraventricular tachydardia(PSVT)is a distinct clinical syndrome. Most patents present with the abrupt onset of palyitatios, dizziness, dyspnea, or chest pain, the electrocardiogram demonstrates a fast heart rate (150-250 beats per min). a regular rhythm, and most often, narrow QRS complexes The p wave is usually hidden within the QRS complex or T wave. PSVT is usually caused by reentry.The most common two electrophysiologica mechanisems of RSVT are atrioventricular nodal reentrant tachycardia and atrioventricular reciprocating tachycardia. For the acute management of PSVT unstable patient require emergent electrical cardioversion. Valsalva maneuver may be attempted in stabke patiemts, If the maneuver is not effective, adenosine is the first-line agent to trea PSVR in most patients. For definite treatment, radiofrequency catheter ablation has been probed to be highly effective. The PSVT can be eradicated with minimal side effects. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。