Vitale P, Santangelo L, Vitale N, Nave C, Civitillo U F, Curcio N, Iacono A
Cattedre di Cardiologia, Facoltà di Medicina e Chirurgia, II Università degli Studi, Napoli.
Cardiologia. 1992 Nov;37(11):775-80.
Electrophysiologic studies in a patient with intermittent ventricular pre-excitation revealed several types of paroxysmal narrow-QRS tachycardia (PSVT). One type of PSVT was characterized by normal retrograde atrial sequences with P waves occurring simultaneously with QRS. This type of PSVT reflected AV nodal reentry with anterograde slow pathway and retrograde fast pathway conduction. A second PSVT reflected alternation of anterograde fast and slow AV nodal pathway conduction and retrograde anomalous pathway conduction. A third PSVT reflected anterograde slow AV nodal pathway and retrograde anomalous pathway conduction. Moreover, discontinuous AV nodal conduction curves (A1A2/H1H2), characteristic of dual AV nodal pathway conduction, were obtained with programmed atrial extra stimulation. These observations suggest that dual AV nodal pathway conduction can coexist with abnormal bypass tract and can be the cause of PSVT in patients with Wolff-Parkinson-White syndrome.
对一名间歇性心室预激患者进行的电生理研究揭示了几种类型的阵发性窄QRS心动过速（PSVT）。一种类型的PSVT的特征是逆行心房顺序正常，P波与QRS同时出现。这种类型的PSVT反映了房室结折返，顺行通过慢径路，逆行通过快径路传导。第二种PSVT反映了顺行快、慢房室结径路传导与逆行异常径路传导的交替。第三种PSVT反映了顺行慢房室结径路和逆行异常径路传导。此外，通过程控心房额外刺激获得了具有双房室结径路传导特征的不连续房室结传导曲线（A1A2/H1H2）。这些观察结果表明，双房室结径路传导可与异常旁路共存，并可能是 Wolff-Parkinson-White 综合征患者PSVT的原因。
