Hokkaido University, Sapporo, Japan.
J Cardiovasc Med (Hagerstown). 2010 May;11(5):327-35. doi: 10.2459/JCM.0b013e328337d42a.
In 1974, Kinoshita reported a case of 'irregular parasystole' due to type I second-degree entrance block. Since then, many cases of such 'irregular' parasystole have been reported by us. To explain the mechanism of 'irregular' parasystole, two theories have been suggested, namely, 'electrotonic modulation' by Jalife and Moe, and 'type I second-degree entrance block' by us. On the contrary, in 1960, Kinoshita et al. reported a case of concealed bigeminy for the first time. The electrocardiographic findings in concealed bigeminy have suggested that there are dual re-entrant pathways with markedly long effective refractory periods in the re-entrant pathway. We have suggested that parasystole may be caused by re-entry in such re-entrant pathways. In this article, attempts are made to explain the mechanism of all the electrocardiographic findings in our cases of parasystole by 'parasystole due to re-entry'.
Using 24 studies on parasystole and 21 studies on concealed extrasystoles that we have reported over 50 years, as well as three exemplary cases in this article, attempts are made to explain all electrocardiographic findings in parasystole by 'parasystole due to re-entry'.
The electrocardiographic findings in our previous clinical cases of parasystole and concealed extrasystoles, as well as exemplary cases and diagrams in the present article, strongly suggest 'parasystole due to re-entry' as the mechanism of ventricular parasystole with second-degree entrance block.
1974 年，Kinoshita 报道了一例因 I 型二度传入阻滞引起的“不规则性并行收缩”。从那时起，我们报告了许多此类“不规则”并行收缩的病例。为了解释“不规则”并行收缩的机制，Jalife 和 Moe 提出了“电调制”理论，而我们提出了“I 型二度传入阻滞”理论。相反，1960 年，Kinoshita 等人首次报道了隐匿性二联律的首例病例。隐匿性二联律的心电图表现表明，在折返径路中有两条具有明显长有效不应期的双重折返径路。我们提出并行收缩可能是由这些折返径路中的折返引起的。在本文中，尝试通过“折返引起的并行收缩”来解释我们的并行收缩病例中的所有心电图表现的机制。
利用我们 50 多年来报告的 24 项并行收缩研究和 21 项隐匿性早搏研究，以及本文中的三个典型病例，尝试通过“折返引起的并行收缩”来解释并行收缩中的所有心电图表现。
我们以前的并行收缩和隐匿性早搏的临床病例中的心电图表现，以及本文中的典型病例和图表，强烈提示“折返引起的并行收缩”是伴有二度传入阻滞的心室并行收缩的机制。
