Hokkaido University, Sapporo, Japan bKatoh Cardiovascular Clinic, Ohtsu, Japan.
J Cardiovasc Med (Hagerstown). 2011 Feb;12(2):131-7. doi: 10.2459/JCM.0b013e32834039bc.
We report here five cases of sinus bigeminy in which comparatively long PP intervals alternated with comparatively short PP intervals, suggesting 'sinus escape-capture bigeminy' or 'sinus extrasystolic bigeminy'. In three of the cases, these two forms of sinus bigeminy were found in the same patient. This is the first study on 'sinus escape-capture bigeminy' alternating with 'sinus extrasystolic bigeminy'. The electrocardiographic findings in these cases suggest the possibility that 'sinus escape' in the sinoatrial junction is not true escape. Attempts are made to explain that apparent sinoatrial junctional escape occurs as a result of markedly slow conduction through the slow sinoatrial pathway, using the concepts of 'dual sinoatrial pathways' and 'double atrial response'.
我们在此报告五例窦律二联律，其中较长的 PP 间期与较短的 PP 间期交替出现，提示“窦房结逸搏夺获性二联律”或“窦房结期前收缩性二联律”。在其中三例中，这两种形式的窦律二联律出现在同一位患者中。这是首次关于“窦房结逸搏夺获性二联律”与“窦房结期前收缩性二联律”交替出现的研究。这些病例的心电图表现提示窦房结结区“逸搏”可能并非真正逸搏。我们尝试使用“双窦房结径路”和“双心房反应”的概念解释，明显缓慢的窦房结慢径路传导可能导致看似窦房结结区逸搏的出现。
