Buja G, Folino A, Martini B, Canciani B, Egloff C, Corrado D, Verlato R, Miorelli M, Nava A
Cattedra e Divisione di Cardiologia dell'Università di Padova.
G Ital Cardiol. 1988 Jul;18(7):560-6.
We present 4 patients aged 51, 19, 22 and 16 years respectively, with no overt heart disease. They complained of recurrent episodes of paroxysmal sustained tachycardia with QRS morphology of right bundle branch block and left fascicular hemiblock. The analysis of the electrocardiogram during the tachycardia and, in two cases, the electrophysiologic study showed a complete a-v dissociation and capture beats confirming the ventricular origin of the arrhythmia. In all the patients the interruption of the tachycardia was obtained by the vagal maneuvers; in two of them the tachycardia was also sensitive to verapamil iv. These cases demonstrate the efficacy of the vagal maneuvers in the termination of fascicular tachycardia and support the hypothesis of slow-response nodal-like fibers, distally displaced, as the anatomical substrate of this arrhythmia.
我们报告了4例患者，年龄分别为51岁、19岁、22岁和16岁，均无明显心脏病史。他们主诉反复出现阵发性持续性心动过速，QRS波形态呈右束支传导阻滞和左束支半阻滞。对心动过速发作时的心电图分析以及其中2例患者的电生理研究显示，存在完全性房室分离和夺获搏动，证实心律失常起源于心室。所有患者通过迷走神经手法均终止了心动过速；其中2例患者的心动过速对静脉注射维拉帕米也敏感。这些病例证明了迷走神经手法在终止分支性心动过速方面的有效性，并支持了如下假说：远端移位的类似结区的慢反应纤维是这种心律失常的解剖学基础。
