Jordaens L, François B, Clément D L
Service de cardiologie, hôpital universitaire, Gand, Belgique.
Arch Mal Coeur Vaiss. 1990 Dec;83(14):2141-5.
A patient with sustained monomorphic ventricular tachycardia developed a second tachycardia of incessant character with alternating RR-interval and alternating QRS-complexes after treatment with amiodarone. A retrograde His bundle deflection was recorded during the latter arrhythmia, that was induced as well with atrial as with ventricular stimulation. The "alternating" tachycardia could be explained by alternating bundle branch reentry and alternating conduction in the myocardium. This view is supported by the finding of an alternating mid-diastolic potential. This case report introduces a new electrocardiographic entity in the spectrum of wide QRS-tachycardias.
一名持续性单形性室性心动过速患者在接受胺碘酮治疗后出现了第二种持续性心动过速，其RR间期和QRS波群交替出现。在后一种心律失常期间记录到逆行希氏束波，心房刺激和心室刺激均可诱发该心律失常。“交替性”心动过速可通过交替性束支折返和心肌交替性传导来解释。舒张中期电位交替出现这一发现支持了这一观点。本病例报告在宽QRS波心动过速谱中引入了一种新的心电图表现。
