Seipel L, Both A, Breithardt G, Loogen F
Am Heart J. 1976 Nov;92(5):623-9. doi: 10.1016/s0002-8703(76)80082-8.
In a patient with complete A-V block suffering from attacks of dizziness an intermittent A-V conduction with a short P-R interval and a delta wave of the conducted ventricular complex were observed. After accelerating the sinus rate by atropine and by exercise, one-to-one conduction was established with QRS complexes of WPW type A configuration. His bundle recordings revealed a complete block within the normal conduction system at the level of the A-V node. A slow junctional rhythm with a normal H-V interval was activating the ventricle. During atrial pacing a one-to-one conduction through an accessory pathway could be documented at cycle lengths between 800 and 380 msec. sandwiched in between zones of complete block at smaller or longer cycle lengths. During ventricular stimulation no retrograde V-A conduction could be observed. The findings support the thesis of at least two functionally different A-V pathways in patients with pre-excitation syndrome.
在一名患有完全性房室传导阻滞且有头晕发作的患者中，观察到间歇性房室传导，其P-R间期短，且下传的心室复合波有δ波。经阿托品和运动使窦性心率加快后，建立了1:1传导，QRS复合波呈A型预激综合征图形。希氏束记录显示在房室结水平的正常传导系统内存在完全性阻滞。一种H-V间期正常的缓慢交界性心律激动心室。在心房起搏时，可记录到在800至380毫秒的周期长度之间通过旁路进行1:1传导，夹在较短或较长周期长度的完全性阻滞区域之间。在心室刺激时，未观察到逆行性室房传导。这些发现支持了预激综合征患者至少存在两条功能不同的房室通路这一论点。
