Ruffy R
Cardiology Division, Jewish Hospital of St. Louis, Washington University Medical Center, Missouri.
Pacing Clin Electrophysiol. 1990 Jul;13(7):852-8. doi: 10.1111/j.1540-8159.1990.tb02121.x.
A 60-year-old woman with a large left ventricular apical aneurysm underwent preoperative catheter mapping of ventricular tachycardia. A zone of slow conduction with marked decremental conductive properties was identified between the left ventricular aneurysmal pouch and the right ventricular septum. Pacing from the right ventricular septum produced a QRS on the surface electrocardiogram of the same morphology as that of spontaneous ventricular tachycardia, while pacing from the left ventricular aneurysm caused tachycardia entrainment without fusion. Termination of ventricular tachycardia invariably occurred in association with an unpropagated left ventricular capture, followed by a change in ventricular activation to an opposite direction. This case provides a direct demonstration of reentrant ventricular tachycardia termination by orthodromic block in a zone of slow conduction.
一名60岁的左心室心尖部巨大动脉瘤女性患者接受了室性心动过速的术前导管标测。在左心室动脉瘤囊袋与右心室间隔之间发现了一个具有明显递减传导特性的缓慢传导区。从右心室间隔起搏产生的体表心电图QRS形态与自发性室性心动过速相同，而从左心室动脉瘤起搏则导致心动过速拖带且无融合。室性心动过速的终止总是与未传导的左心室夺获相关，随后心室激动方向改变。该病例直接证明了在缓慢传导区通过顺向阻滞终止折返性室性心动过速。
