Fujiki A, Yoshida S, Tani M, Sasayama S
Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Japan.
J Electrocardiol. 1988 Jan;21(1):77-82. doi: 10.1016/s0022-0736(88)80027-x.
A 65-year-old man with Wolff-Parkinson-White syndrome type A had a rapid ventricular response over an accessory pathway during atrial fibrillation. Four months later, electrophysiological study revealed the following properties: 1) The antegrade accessory pathway conduction showed phase 3 and phase 4 block. 2) The retrograde concealed accessory pathway conduction eliminated phase 4 block in the antegrade accessory pathway conduction. 3) Premature ventricular excitation arose from the accessory pathway or from the ventricular muscle close to its distal end. 4) Atrial fibrillation during isoproterenol infusion did not show rapid ventricular response. Spontaneous impairment of accessory pathway conduction due to phase 3 and phase 4 block was suspected.
一名65岁的A型预激综合征男性患者在房颤期间通过旁路出现快速心室反应。四个月后，电生理研究显示以下特征：1）前向旁路传导表现出3相和4相阻滞。2）逆向隐匿性旁路传导消除了前向旁路传导中的4相阻滞。3）室性早搏激动起源于旁路或其远端附近的心室肌。4）异丙肾上腺素输注期间的房颤未表现出快速心室反应。怀疑存在由于3相和4相阻滞导致的旁路传导自发损害。
