| Objective:To compare the result of inducing atrioventricular nodal reentrant tachycardia(AVNRT)after the injection of atropine or caiglucon to the patients of dual atrial ventricular node pathway(DAVNP).To analyze the affect of this two types of revulsive and the effect to the inducing results.Methods:To those sufferring cardiopalmus without the taboo of atropine and calglucon,after the cardiac electrophysiology examination—transesophageal atrial pacing(TEAP)by inserting 6F quadrupole catheter through nasal cavity,adjusting voltage and given incrementalpacing(S1S1)and programmed ectopic stimulation(S1S2,S1S2S3)by Suzhou DF-5A cardiac electrophysiology stimulator in our hospital,choosing 62 patients who were diagnosed DAVNP without AVNRT after three turns of reverse scanning,divided them into two groups randomly:Calglucon group—to inject 100ml of 5%glucose and 20ml of 10%calglucon;Atropin group—to inject 2mg or 0.04mg/kg atropin.After the injection,the same process was repeated.To survey the electrophysiological parameter of the heart after the injection of the drug and to compare the effect of inducing AVNRT of the two type of drug with the Cardiosoft system.Results:1.After the quick injection of 100ml of 5%glucose and 20ml of 10% calglucon:①Heart rate:The RR interval extends from 803.6±124.4ms to 851.1±89.2ms(p＜0.05),that is the heart rate rev down.②Atrial ventricular node conduction function:The Wenckebach phenomenon of atrioventricular conduction changes from 147.8±11.5ppm to 139.6±16.8ppm in advance,but the difference is not significant(p＞0.05). ③Effective refractory period of the atrial ventricular node:The effective refractory period of the fast node pathway extends from 375.0±60.2ms to 422.7±93.3ms(p＜0.01).The effective refractory period of the slow node pathway extends from 285.0±22.8ms to 300.8±45.0ms,but the difference is not significant(p＞0.05).The gap of the effective refractory period between the fast and the slow node pathway extends from 77.5±47.7ms to 130.0±20.9ms(p＜0.05).④The conduction time of the fast,slow node pathways:The conduction time of the fast node pathways shortens from 203.8±35.1ms to 188.3±58.4ms,but the difference is not significant(p＞0.05).The conduction time of the slow node pathways extends from 383.8±95.2ms to 408.8±88.1ms,but the difference is not significant(p＞0.05).The jump of the S2R interval extends from 176.7±100.3ms to 218.2±88.6ms(p＜0.05).⑤The atrial effective refractory period:The atrial effective refractory period shortens from 185.6±18.1ms to 174.4±8.8ms(p＜0.05).2.After the injection of 2mg of atropin:①Heart rate:The RR interval shortens from 847.9±135.0ms to 582.3±75.5ms(p＜0.01),that is the heart rate speed up.②Atrial ventricular node conduction function:The Wenckebach point of atrioventricular conduction delays from 139.6±23.3ppm to 193.5±9.3ppm(p＜0.01).③Effective refractory period of the atrial ventricular node:The effective refractory period of the fast node pathway shortens from 396.3±42.3ms to 280.0±44.9ms(p＜0.01).The effective refractory period of the slow node pathway shortens from 307.0±29.8ms to 236.0±54.0ms(p＜0.01).The gap of the effective refractory period between the fast and the slow node pathway shortens from 100.0±43.7ms to 43.0±16.4ms(p＜0.01).④The conduction time of the fast,slow node pathways:The conduction time of the fast node pathway shortens from 215.2±53.3ms to 154.8±16.6ms(p＜0.01).The conduction time of the slow node pathway shortens from 363.8±47.4 to 215.7±21.8ms(p＜0.01).The jump of the S2R interval shortens from 148.6±60.8ms to 61.0±19.5ms(p＜0.01).⑤The atrial effective refractory period:The atrial effective refractory period shortens from 174.2±18.8ms to 135.0±55.5ms(p＜0.05).3.Calglucon dosen't change the number of patients with jumping Wenckebach phenomenon.In the atropin group,13 in 21 patients aren't made a diagnosis of jumping Wenckebach phenomenon once more.4.There are 18 and 16 patients in calgiucon group and atropin group separaterly who are made a diagnosis of DAVNP and AVNRT or single or double atrioventricular nodal reentrant or atrial echo beat,but the difference is not significant;The whole inducing rate to the three are 60%and 50%separaterly, but the difference is not significant;And there is no difference between the two groups in the number of patients made a diagnosis of DAVNP only;But in the atropin group,there are more patients who aren't made a diagnosis of DAVNP once more(p＜0.01).Conclusions:1.Calglucon rev down the heart rate,but atropin speed up the heart rate.2.Calglucon dose not have a significant impact to the Wenckebach phenomenon of atrioventricular conduction,but atropin delays the Wenckebach point of atrioventricular conduction significantly.3.Calglucon have no significant impact to the jumping Wenckebach phenomenon,but atropin make some patients have no jumping Wenckebach phenomenon once more.4.Calglucon extends the effective refractory period of the fast node pathway, have no significant impact to the effective refractory period of the slow node pathway,and extends the gap of the effective refractory period between the fast and the slow node pathway;but atropin shortens the three significantly.5.Calglucon shortens the conduction time of the fast node pathways slightly, extends the conduction time of the slow node pathways slightly,and extends the jump of the S2R interval;but atropin shortens the three significantly.6.Both Calglucon and atropin shorten the atrial effective refractory period.7.Calglucon has a whole inducing rate of 60%to DAVNP and AVNRT or single or double atrioventricular nodal reentrant or atrial echo beat and is higher than atropin's 50%,but there is no significant difference between the two. |
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