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介绍一种新的电生理方法可快速准确地诊断隐匿性后间隔旁路。方法：右室心尖部和基底部起搏，比较１２例隐匿性后间隔旁路（Ａ组）和２０例房室结双径路（Ｂ组）患者的室房传导时间（ＶＡＩ）。结果：①心尖部起搏时Ａ组ＶＡＩ（１８６±３９）ｍｓ与Ｂ组（１７１±３２）ｍｓ相比，无显著性差异（Ｐ＞０．０５）；②基底部起搏时Ａ组ＶＡＩ（１４４±３１）ｍｓ明显短于Ｂ组（１９４±３３）ｍｓ；两者有显著性差异（Ｐ＜０．０１）；③两部位（心尖部和基底部）ＶＡＩ之差值ＶＡｉｎｄｅｘ，Ａ组≥１０［１０～８０，平均（３０±２６）］与Ｂ组≤０［－５５～０，平均（－２３±１６）］比较有极显著性差异（Ｐ＜０．００１）。结论：右室心尖部和基底部起搏可快速准确地判断室房逆传径路是后间隔旁路还是房室束。
A new electrophysiological method is introduced to quickly and accurately diagnose occult bypass. Methods: Right atrial apices and basal pacing were performed. Ventricular conduction time (VAI) was compared between 12 patients with concealed posterior septal bypass (group A) and 20 patients with dual junctional approach (group B). Results: ① There was no significant difference in VAI (186 ± 39) ms between group A and group B (171 ± 32) ms when apical pacing was performed (P> 0.05) (144 ± 31) ms was significantly shorter than that in group B (194 ± 33) ms; the difference between the two was significant (P <0.01); ③ The difference in VAI between the two sites (apical and basal) VAindex, ≥10 [10 ~ 80, mean (30 ± 26)] and group B ≤0 [-55 ~ 0, mean (-23 ± 16)] compared with very significant difference (P <0.001). Conclusion: Right ventricular apical and basal pacing can quickly and accurately determine whether the retrograde pathway is posterior septum bypass or atrioventricular bundle.