Orczykowski Michał, Derejko Paweł, Bodalski Robert, Szufladowicz Ewa, Zakrzewska Joanna, Urbanek Piotr, Kepski Roman, Przybylski Andrzej, Szumowski Lukasz, Walczak Franciszek
Klinika Zaburzeń Rytmu Serca, Instytut Kardiologii, ul Alpejska 42, 04-628 Warszawa, Poland.
Kardiol Pol. 2007 May;65(5):603-7.
We present a case of 53-year-old patient who experienced paroxysms of wide QRS complex tachycardia at a rate of 150 bpm and LBBB morphology 6 years after inferior myocardial infarction and CABG. Anamnesis and morphology of tachycardia could suggest ventricular tachycardia. However during electrophysiological study we observed AVRT with LBBB and "regularly irregular" AVRT with normal QRS complex and changing entrance to the AV node (through slow and fast pathway). In this paper we present our approach and try to explain why the tachycardia using concealed bypass tract appeared so late in life.
我们报告一例53岁患者，在发生下壁心肌梗死和冠状动脉旁路移植术6年后，出现宽QRS波群心动过速发作，心率为150次/分，呈左束支传导阻滞形态。心动过速的病史和形态可能提示室性心动过速。然而，在电生理研究中，我们观察到呈左束支传导阻滞的房室折返性心动过速以及QRS波群正常且房室结折返入口改变（通过慢径和快径）的“规则性不规则”房室折返性心动过速。在本文中，我们展示了我们的方法，并试图解释为何使用隐匿性旁路传导束的心动过速在生命后期才出现。
