长RP间期心动过速。其机制是什么？

Long RP interval tachycardia. What is the mechanism?

作者信息

Jiménez-Díaz Javier, González-Marín María-Arantzazu, González-Ferrer Juan J, Higuera-Sobrino Felipe

机构信息

Unidad de Arritmias, Servicio de Cardiología, Hospital General de Ciudad Real, Ciudad Real, España.

Unidad de Arritmias, Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, España.

出版信息

J Arrhythm. 2017 Jun;33(3):242-244. doi: 10.1016/j.joa.2016.06.004. Epub 2016 Aug 31.

DOI:10.1016/j.joa.2016.06.004

PMID:28607623

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5459351/

Abstract

A 41-year-old man with a history of tachycardia refractory to multiple antiarrhythmic drugs was sent to our institution. His 12-lead electrocardiogram demonstrated incessant narrow QRS complex tachycardia with negative waves in the inferior leads and long RP interval. Occasionally, the tachycardia terminated after a wave and then was restarted after a sinusal beat. An EP study was performed during tachycardia. Intracardiac electrograms during tachycardia and response to pacing maneuvers are shown. What is the tachycardia mechanism?

摘要

一名41岁男性，有多种抗心律失常药物治疗无效的心动过速病史，被送至我院。他的12导联心电图显示持续性窄QRS波群心动过速，下壁导联有负向波，RP间期长。偶尔，心动过速在一个a波后终止，然后在窦性搏动后重新开始。在心动过速发作期间进行了电生理检查。图中显示了心动过速发作时的心内电图及对起搏操作的反应。心动过速的机制是什么？