大动脉转位矫正术后患者出现正常心率下窄QRS波规整心律的诊断困境。

Shenthar Jayaprakash, Rai Maneesh K

Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bannerghatta Road, Jayanagar 9th Block, Bangalore 560069, Karnataka, India.

Indian Pacing Electrophysiol J. 2015 Oct 19;15(3):180-3. doi: 10.1016/j.ipej.2015.10.003. eCollection 2015 May-Jun.

A 35 year old male, known case of corrected transposition of great arteries presented with exertional dyspnea and recurrent pre-syncope. 12 lead electrocardiogram revealed a regular rhythm at 75 beats per minute, P waves occurring on the upstroke of T waves and apparent 1:1 P-QRS relationship. The possibilities to be considered - complete AV block with junctional escape, junctional rhythm with 1:1 retrograde conduction, junctional rhythm with isorhythmic AV dissociation and prolonged PR interval have been discussed.

一名35岁男性，已知患有矫正型大动脉转位，出现劳力性呼吸困难和反复前驱晕厥。12导联心电图显示心律规则，每分钟75次搏动，P波出现在T波的上升支，且P-QRS关系明显为1:1。已讨论了需要考虑的可能性——伴有交界性逸搏的完全性房室传导阻滞、伴有1:1逆向传导的交界性心律、伴有等律性房室分离的交界性心律以及PR间期延长。