Schmitt C, Miller J M, Josephson M E
Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, Philadelphia 19104.
Pacing Clin Electrophysiol. 1988 Jul;11(7):1018-23. doi: 10.1111/j.1540-8159.1988.tb03946.x.
A patient with narrow complex supraventricular tachycardia underwent electrophysiological study at which time a tachycardia was initiated which had 2:1 AV conduction, with block occurring above the His bundle. The modes of tachycardia initiation, as well as the responses to atrial and ventricular premature depolarizations during tachycardia, made a diagnosis of atrioventricular nodal reentry as the tachycardia mechanism. The unusual finding of 2:1 supra-His block suggests the presence of tissue situated between the tachycardia circuit and His bundle, and effectively excludes the possibility of a His-atrial bypass tract as the retrograde limb of the tachycardia circuit.
一名窄QRS波群室上性心动过速患者接受了电生理检查，当时诱发了一种心动过速，其房室传导比例为2:1，阻滞发生在希氏束上方。心动过速的诱发方式以及心动过速期间对房性和室性期前除极的反应，诊断心动过速机制为房室结折返。希氏束上方2:1阻滞这一不寻常的发现提示在心动过速环路与希氏束之间存在组织，从而有效排除了希氏束-心房旁路作为心动过速环路逆行支的可能性。
