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窦房结(SN)是正常心脏的起搏点.SN 及其周围病变均可导致SN 自律性和(或)传导功能障碍,临床上表现为各种窦性心律失常.评价SN 功能的方法有多种,但各有其局限性.临床心脏电生理学的发展为SN 功能判定提供了新途经.常用的电生理指标有窦房结恢复时间(SNRT),窦房传导时间(SACT)和窦房结有效不应期(SNERP).其中以SNRT 诊断价值较高.本文拟就其历史、现状、方法,临床应用和其局限性结合作者的工作体会做一简要综述.1884年Gaskell 在海龟实验中首次证明用高于SN 自身固有频率的电脉冲刺激心房时可以抑制SN的起搏功能,发现心脏具有超速抑制现象。其后的临床报道相继予以强调。根据这些临床观察,Lange对SN 的超速抑制作了系统的实验研究,发现超速刺激结束后SN 较低位起搏点受抑程度轻。1971年
Sinus node (SN) is a normal cardiac pacemaker, SN and its surrounding lesions can lead to SN self-regulation and / or conduction dysfunction, the clinical manifestations of various sinus arrhythmias. SN method to evaluate the function of But each has its own limitations.The development of clinical cardiac electrophysiology provides a new way to determine the function of SN.The commonly used electrophysiological indexes include sinus node recovery time (SNRT), sinoatrial conduction time (SACT) and sinoatrial Knot effective refractory period (SNERP), of which SNRT diagnostic value is higher.This article intends to make a brief overview of its history, status quo, methods, clinical applications and their limitations combined with the author’s work experience .1884 Gaskell in turtle experiment It is the first time to prove that the pacing function of SN can be inhibited by stimulating the atria with electrical impulses above the natural frequency of SN and the heart is found to have the phenomenon of overspeed inhibition. Subsequent clinical reports have been emphasized. Based on these clinical observations, Lange conducted a systematic experimental study on the oversupply of SN, and found that the SN lower-level pacemaker was less depressed after the overspeed stimulation. 1971