발작성 상실성 빈맥 환자의 응급실 내 치료 결과 및 재발 인자에 관한 분석 = Analysis of Factors Predicting Recurrence and the Result of Treatment in PSVT Patients at the Emergency Department

다국어 초록 (Multilingual Abstract)

Purpose: The purpose of this research was to evaluate the factors predicting recurrence and the characteristics of patients who recurred after the treatment of spontaneous paroxysmal supraventricular tachycardia (PSVT) with adenosine.
Methods: From January 1999 to December 2001, 62 patients with PSVT were enrolled in this study. The conversion group included patients who had had a therapeutic response, which was defined as the occurrence of a change in the sinus rhythm after adenosine administration. The recurred group consisted of all patients who had not had a therapeutic response. Clinical features, the results of treatment, ECG findings, and the hemodynamic statuses were analyzed.
Results: The treatments were vagal maneuver (5 pts, 7.5%), adenosine 6 ㎎ (37 pts, 55.2%), adenosine 12 ㎎ (14 pts, 20.9%), verapamil 5 ㎎ (9 pts, 13.4%), and cardioversion (2 pts, 3.0%). Twenty-five of the 62 patients failed to have a therapeutic response, yielding a recurrence rate of 40.3%. Atrioventricular reentrant tachycardia (AVRT) was more prevalent in the recurred group. The most common symptom at presentation was chest pain. The recurred group had increased heart rate, and increased blood pressure. When patients were monitered after adenosine, unifocal premature ventricular complex was the most common rhythm encountered in the conversion group, but atrial fibrillation, and multifocal premature ventricular complex was the most common rhythm encountered.
Conclusion: Age, heart rate, difference in systolic blood pressure from presentation to discharge, previous history of heart disease, and rhythms encountered after adenosine administration ere factors predicting recurrence.

목차 (Table of Contents)

• 서 론
• 대상과 방법
• 1. 연구 대상
• 2. 연구대상의 분류
• 2-1. 전환군
• 2-2. 재발군
• 3. 재발에 미치는영향 분석
• 3-1. 임상 양상 분석
• 3-2. Adenosine 투여후 심전도 분석
• 3-3. 혈역학적 분석
• 4. 통계
• 결 과
• 1. 연구대상자의 일반적 특성
• 2. 내원시 증상과 응급실에서치료 결과
• 3. adenosine 투여 후 나타난 부정맥의 분석
• 4. 혈역학적 변화에 따른 분석
• 4-1. 심박동수 비교
• 4-2. 내원시와 퇴원시의수축기압차이의 비교
• 고 찰
• 결 론