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개에서 인공 심조율로 조성된 상실성 빈맥의 혈역학적 변화
조은주(Eun Ju Cho),김재형(Jae Hyung Kim),노태호(Tai Ho Rho),진승원(Seung Won Jin),김희열(Hee Yeol Kim),이만영(Man Young Lee),김종진(Chong Jin Kim),채장성(Jang Seong Chae),홍순조(Soon Jo Hong),최규보(Kyu Bo Choi) 대한내과학회 2002 대한내과학회지 Vol.62 No.1
N/A Background: Tachyarrhythmias have various clinical features according to their tachycardia rates, systolic function of the left ventricle, the origin site and the mechanisms. Atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) might cause different hemodynamic changes due to their different mechanisms. Methods: To evaluate the hemodynamic differences of supraventricular tachycardias, atrial tachycardia (atrial pacing with AOO mode, 180/min, group I), AVRT (VA pacing interval 80 msec with DOO mode, 180/min, group II) and AVNRT (VA pacing interval 0 msec, 25 msec with DOO mode, 180/ min, group III) were simulated in eleven dogs. Hemodynamic parameters were systemic arterial pressure including systolic, mean and diastolic arterial pressure (SAP, MAP, DAP respectively), mean pulmonary arterial wedge pressure (MPAWP) and cardiac output (CO). Results: The MAP was highest in group I (87.0±20.4mmHg) and decreased with decreasing VA interval of no significance. The SAP was higher in group II (109.8±22.6mmHg) than in group III (95.3±27.1mmHg) (p <0.05). The level of MPAWP had no significant differences among three groups and showed no peculiar pattern with changes of VA interval. The CO was higher in group I (1.18 ±0.32 L/ min) than in other two groups with significant difference (p <0.01) and decreased with shortening of VA interval without significance. Conclusion: Above result s suggested that the AVRT and AVNRT have different effects on hemodynamic changes, those from different timing of atrial contraction, especially on SAP and CO. So hemodynamic compromise during tachycardia could be more severe in AVNRT than in AVRT inspite of their similar QRS morphology and tachycardia rate.(Korean J Med 62:35- 41, 2002)