Amasyali Basri, Kose Sedat, Celik Turgay
Department of Cardiology, Gulhane Military Medical Academy, Etlik, Ankara, Turkey.
Europace. 2006 Feb;8(2):134-7. doi: 10.1093/europace/euj033. Epub 2006 Jan 10.
QRS voltage and cycle length alternation can be seen during supraventricular re-entrant tachycardias, especially in atrioventricular (AV) re-entrant tachycardia. We present a case of a 20-year-old man, in which AV nodal re-entrant tachycardia (AVNRT) shows alternation of QRS voltage and cycle length, as well as right bundle branch block aberration due to a re-entrant circuit using two distinct, beat-to-beat alternating slow AV nodal pathways antegradely and a single fast pathway retrogradely. Although more than one antegrade slow pathway exists, creation of a single lesion at the right posterior atrial septum using the conventional right-sided approach successfully eliminated AVNRT.
室上性折返性心动过速期间可见QRS电压和心动周期长度交替，尤其是在房室（AV）折返性心动过速中。我们报告一例20岁男性病例，其中房室结折返性心动过速（AVNRT）表现出QRS电压和心动周期长度交替，以及由于折返环使用两条不同的、逐搏交替的慢房室结通路前向传导和一条快通路逆向传导而导致的右束支传导阻滞异常。尽管存在多条前向慢通路，但采用传统右侧入路在右后房间隔处制造单个消融灶成功消除了AVNRT。
