Extramiana Fabrice, Takatsuki Seiji, Hayashi Meiso, Leenhardt Antoine
Department of Cardiology, Lariboisière Hospital, APHP, Paris 7 University, Paris, France.
Europace. 2007 Oct;9(10):920-2. doi: 10.1093/europace/eum183. Epub 2007 Sep 5.
To show 2 examples in which the analysis of the effect of bundle branch block on orthodromic reciprocating tachycardia cycle length was misleading.
We performed an electrophysiological study in two patients with orthodromic reciprocating tachycardia showing a transition from wide to narrow QRS during tachycardia. Our two cases of left bundle branch block during reciprocating tachycardia using infero-septal pathways show that ventricular to atrial conduction time prolongation may be larger than 30 ms and may be concealed by a shortening of atrial to ventricular conduction time. In the 2 cases, the atrial insertion of the accessory pathway could be successfully ablated from the right atria at the ostium of the coronary sinus.
The observation of the association between left bundle branch block and cycle length prolongation during reciprocating tachycardia may be associated with a successful ablation at the ostium of the coronary sinus.
展示两例束支传导阻滞对顺向型房室折返性心动过速周期长度影响的分析产生误导的例子。
我们对两名顺向型房室折返性心动过速患者进行了电生理研究，这两名患者在心动过速期间呈现QRS波群由宽变窄。我们的两例使用下间隔途径的折返性心动过速伴左束支传导阻滞病例显示，心室至心房传导时间延长可能大于30毫秒，且可能被心房至心室传导时间缩短所掩盖。在这两例中，旁路的心房插入端可在冠状窦口从右心房成功消融。
观察到左束支传导阻滞与折返性心动过速期间周期长度延长之间的关联可能与在冠状窦口成功消融有关。
