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[双火所致心动过速——同时性双房室结传导:一种罕见或诊断不足的心律失常?3例患者的心电图表现谱]

[Tachycardia caused by a double fire - simultaneous double atrioventricular nodal conduction: a rare or underdiagnosed arrhythmia? Spectrum of electrocardiographic pictures in three patients].

作者信息

Jastrzebski Marek, Kukla Piotr

机构信息

Klinika Kardiologii i Nadciśnienia Tetniczego, Szpital Uniwersytecki, ul. Kopernika 17, 31-501 Kraków.

出版信息

Kardiol Pol. 2009 Jan;67(1):77-84; discussion 85-6.

Abstract

We describe three patients with incessant supraventricular arrhythmia known as nonreentrant supraventricular tachycardia that is caused by double atrioventricular nodal conduction of each sinus beat. Electrocardiograms showing various patterns of atrioventricular conduction are presented. These include Wenckebach periodicity with AV block in both AV nodal pathways, only in slow pathway, only in fast pathway or picture mimicking a regular supraventricular tachycardia with T wave pseudo-alternans. We propose a new name for this arrhythmia: AV nodal dual response bigeminy. All three cases were successfully treated with radiofrequency ablation: two of slow pathway and one of AV node.

摘要

我们描述了三名患有持续性室上性心律失常的患者,这种心律失常被称为非折返性室上性心动过速,由每个窦性搏动的双房室结传导引起。文中展示了显示各种房室传导模式的心电图。这些模式包括房室结两条径路均出现房室阻滞的文氏周期、仅在慢径路出现房室阻滞、仅在快径路出现房室阻滞,或表现为类似伴有T波假性交替的规则室上性心动过速的图形。我们为此种心律失常提出一个新名称:房室结双反应性二联律。所有三例患者均通过射频消融成功治愈:两例消融慢径路,一例消融房室结。

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