心房颤动时出现交替性束支阻滞。

Bundle branch block on alternate beats during atrial fibrillation.

作者信息

Carbone Vincenzo, Carerj Scipione, Calabrò Maria Pia

机构信息

Department of Cardiology, Universiry of Messina, Messina, Italy.

出版信息

J Electrocardiol. 2004 Jan;37(1):67-72. doi: 10.1016/j.jelectrocard.2003.11.002.

DOI:10.1016/j.jelectrocard.2003.11.002

PMID:15132372

Abstract

This article reports a case of tachycardia-dependent right bundle branch block (RBBB) occurring during atrial fibrillation. In some sections of the recording, an alternans occurs between complexes with a complete RBBB pattern and complexes showing normal intraventricular conduction or incomplete RBBB. Alternans is frequently observed during phases of fast and nearly regular rhythm, but it occurs even in the presence of a markedly irregular ventricular response. The RBBB alternans associated with short and regular RR intervals is likely to represent a manifestation of 2:1 bundle branch supernormal conduction, whereas alternans occurring with irregular cycles expresses a complex interaction between the RR cycle length and some mechanisms affecting intraventricular conduction, such as tachycardia-dependent bundle branch block, supernormal conduction and concealed retrograde activation of the anterogradely blocked bundle branch (the so-called "linking" phenomenon).

摘要

本文报道了1例心房颤动期间发生的心动过速依赖性右束支传导阻滞（RBBB）。在记录的某些时段，完全性RBBB图形的复合波与显示正常室内传导或不完全性RBBB的复合波之间出现了交替现象。交替现象常在快速且近乎规则的心律阶段频繁出现，但即使在心室反应明显不规则的情况下也会发生。与短而规则的RR间期相关的RBBB交替现象可能代表2∶1束支超常传导的一种表现，而不规则周期出现的交替现象则表现为RR周期长度与某些影响室内传导的机制之间的复杂相互作用，如心动过速依赖性束支传导阻滞、超常传导以及前向阻滞束支的隐匿性逆行激动（所谓的“连接”现象）。