Di Biase M, Favale S, Rizzo U, Minafra F, Rizzon P
Division of Cardiology, University of Bari, Italy.
Eur Heart J. 1988 Mar;9(3):295-300. doi: 10.1093/oxfordjournals.eurheartj.a062500.
The incidence of 'dual A-V nodal pathways', diagnosed on the basis of spontaneous or induced modifications in the PR interval, has been assessed in a group of 168 consecutive patients with first- (77) and second-degree (91) type I supra-His block. 'Dual A-V nodal pathways' were found in 12 cases (16%) with first-degree and in 7 cases (7.7%) with second-degree type I supra-His A-V block. His bundle recording confirmed the hypothesis that PR interval variations observed in these cases are due to modifications in the AH interval and thus to changes in A-V nodal conduction velocity. The electrophysiologic study also showed that the phenomenon was easily reproduced by atrial stimulation. The frequent association between 'dual A-V nodal pathways' and supra-His blocks suggests that the block mechanism should be studied in depth as it could have prognostic and therapeutic implications.
在一组168例连续的一度（77例）和二度（91例）I型希氏束以上阻滞患者中，评估了基于PR间期自发或诱发改变诊断的“双房室结径路”的发生率。在12例（16%）一度和7例（7.7%）二度I型希氏束以上房室阻滞患者中发现了“双房室结径路”。希氏束记录证实了这样的假设，即这些病例中观察到的PR间期变化是由于AH间期的改变，从而是由于房室结传导速度的变化。电生理研究还表明，该现象通过心房刺激很容易再现。“双房室结径路”与希氏束以上阻滞之间的频繁关联表明，应深入研究阻滞机制，因为它可能具有预后和治疗意义。
