Kovaleva L I, Nikiforova T B, Paleev N R
Kardiologiia. 1985 Apr;25(4):75-80.
Mechanisms involved in the development of parasystole and extrasystole are substantiated on the basis of vast clinical material (261 patients with parasystole and 45 with extrasystole). The use of functional tests employing exercise and atropine contributed to both the correct diagnosis of parasystole and extrasystole and a logical explanation of the mechanisms governing their development. Prolonged ECG recording identified, for the first time ever, the limits of the maximum admissible coupling interval for normotopic extrasystole, as the preliminary diagnosis of the nature of the arrhythmia was only made after the said tests. Parasystole was shown to be rooted in a pathologic automatism, and extrasystole, in the summation of extrasystolic focus potentials and the principal pacemaker potential during movement as well as the principal pacemaker impulse along the route of the minor circular wave on Purkinje' level. The localization of ectopic foci in parasystole and extrasystole confirms the hypothesis of the mechanisms involved in these arrhythmias. A parallel study of parasystole and extrasystole defined parasystole as active heterotopia, and extrasystole, as passive heterotopia incapable of generating a rhythm.
根据大量临床资料（261例并行心律患者和45例早搏患者）证实了并行心律和早搏发生的机制。采用运动和阿托品的功能试验有助于正确诊断并行心律和早搏，并对其发生机制作出合理的解释。长时间心电图记录首次确定了正常节律性早搏的最大允许联律间期范围，因为心律失常性质的初步诊断仅在上述试验后作出。结果表明，并行心律源于病理性自律性，而早搏则源于运动期间早搏灶电位与主要起搏点电位的总和，以及浦肯野纤维水平上沿小环形波路径的主要起搏点冲动。并行心律和早搏中异位灶的定位证实了这些心律失常发生机制的假说。对并行心律和早搏的平行研究将并行心律定义为主动性异位，而早搏则为无节律产生能力的被动性异位。
