Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Rev Cardiovasc Med. 2010 Winter;11(1):44-52. doi: 10.3909/ricm0494.
Certain electrocardiographic patterns are well recognized for their propensity to progress to more severe forms of atrioventricular (AV) block, thus requiring pacemaker implantation. This article presents an infrequently recognized and deceptively benign pattern of conduction abnormality with great potential for advancement to severe AV block and necessity for pacemaker therapy. The pattern consists of alternating bundle branch block (BBB) in unison with alternation of the PR interval so that the right BBB beats and left BBB beats appear to be wedded to their own but different PR intervals. It is hoped that the publication of these cases will contribute to the awareness of practicing cardiologists and electrophysiologists to the existence of this potentially serious form of AV conduction abnormality and hasten the implantation of pacemakers in patients who require them.
某些心电图模式因其易于进展为更严重的房室（AV）传导阻滞而被广泛认识，因此需要植入起搏器。本文介绍了一种不常见但具有欺骗性的传导异常模式，其具有进展为严重 AV 传导阻滞并需要起搏治疗的巨大潜力。该模式表现为束支传导阻滞（BBB）交替出现，同时 PR 间期也交替变化，使右束支传导阻滞和左束支传导阻滞似乎与各自不同的 PR 间期相匹配。希望发表这些病例将有助于提高临床心脏病学家和电生理学家对这种潜在严重形式的 AV 传导异常的认识，并促使需要起搏器的患者尽快植入起搏器。
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