Yokoshiki Hisashi, Sasaki Koji, Shimokawa Junichi, Sakurai Masayuki, Tsutsui Hiroyuki
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan.
J Electrocardiol. 2006 Oct;39(4):395-9. doi: 10.1016/j.jelectrocard.2005.08.017. Epub 2005 Nov 10.
We report a case of complex supraventricular tachycardia manifested by radiofrequency delivery. Initially, the patient presented with orthodromic atrioventricular reentrant tachycardia via a left-sided accessory pathway that was successfully eliminated. Atrial tachycardia originating from coronary sinus ostium was also induced. Radiofrequency delivery at the coronary sinus ostium induced a narrow QRS tachycardia with irregular R-R intervals. A detailed analysis explained that the tachycardia could be a nonreentrant mechanism due to triple atrioventricular nodal pathways: an atrial excitation evokes double ventricular response due to simultaneous activation of the fast and slow pathways, and the next one activates ventricle through the intermediate pathway.
我们报告了一例通过射频消融表现出的复杂室上性心动过速病例。最初，患者表现为经左侧旁路的顺向房室折返性心动过速，该心动过速已成功消除。还诱发了起源于冠状窦口的房性心动过速。在冠状窦口进行射频消融诱发了QRS波群狭窄的心动过速，其R-R间期不规则。详细分析表明，该心动过速可能是由于三房室结径路导致的非折返机制：心房激动由于快径路和慢径路的同时激活而引起双心室反应，下一次则通过中间径路激活心室。
