Kuck K H, Schlüter M, Kunze K P, Geiger M
Department of Cardiology, University Hospital Eppendorf, Hamburg, F.R.G.
Pacing Clin Electrophysiol. 1989 Jul;12(7 Pt 1):1055-64. doi: 10.1111/j.1540-8159.1989.tb01926.x.
A case is presented of a patient with incessant ventricular tachycardia of left bundle branch block morphology. Endocardial mapping revealed the site of earliest activation during tachycardia to be the proximal right ventricular septum. Pacing at this site elicited the clinical tachycardia, whereas pacing at the proximal left ventricular septum induced a right bundle branch block morphology identical to that of a previously recorded spontaneous ventricular tachycardia. Electrophysiological evidence is given that both types of tachycardia originate from a single reentry circuit located in the proximal ventricular septum in which the reentrant wavefront may travel either orthodromically (during spontaneous tachycardia and right ventricular pacing) or antidromically (during left ventricular pacing).
本文报道了1例持续发作的左束支传导阻滞形态室性心动过速患者。心内膜标测显示，心动过速发作时最早激动部位为右心室间隔近端。在此部位起搏可诱发临床心动过速，而在左心室间隔近端起搏则诱发了与既往记录的自发性室性心动过速相同的右束支传导阻滞形态。电生理证据表明，这两种类型的心动过速均起源于位于心室间隔近端的单个折返环，折返波前在其中可沿顺向传导（在自发性心动过速和右心室起搏时）或逆向传导（在左心室起搏时）。
