Hirai J, Nishimura M, Matoba M, Akashi Y, Saga T, Watanabe Y
Department of Medicine, Fukui Prefectural Hospital, Japan.
Pacing Clin Electrophysiol. 1989 Sep;12(9):1451-7. doi: 10.1111/j.1540-8159.1989.tb06149.x.
A 43-year-old female with a chief complaint of palpitation was subjected to clinical electrophysiological studies. Initial standard 12-lead ECG revealed that her palpitation was caused by fascicular parasystole firing at the basic cycle length of 1.25-1.40 seconds, and that both sinus and parasystolic beats were associated with left anterior fascicular block and tachycardia-dependent RBBB. His-bundle electrocardiogram suggested that the parasystolic focus was located in the proximal portion of the anterior fascicle of the left bundle branch and that the site of tachycardia-dependent conduction block was located in the main right bundle branch. These findings suggest that diffuse pathological changes in the intraventricular conducting system were responsible for both the conduction block and automatic impulse formation in the present case.
一名43岁女性，以心悸为主诉，接受了临床电生理研究。初始标准12导联心电图显示，其心悸是由逸搏周期为1.25 - 1.40秒的分支性并行心律引起的，窦性和并行心律性搏动均伴有左前分支阻滞和心动过速依赖性右束支传导阻滞。希氏束心电图提示，并行心律起源部位位于左束支前分支近端，心动过速依赖性传导阻滞部位位于右束支主干。这些发现提示，本例患者室内传导系统的弥漫性病理改变是导致传导阻滞和自动冲动形成的原因。
