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房室传导突然意外改善。机制是什么？

Sudden unexpected improvement in the atrioventricular conduction. What is the mechanism?

作者信息

Gupta Anunay, Bhargava Kartikeya, Bhasin Dinkar, Agstam Sourabh, Isser Hermohander Singh

机构信息

Department of Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

Department of Cardiology, Medanta-The Medicity, Gurugram, India.

出版信息

Indian Pacing Electrophysiol J. 2021 Jul-Aug;21(4):248-250. doi: 10.1016/j.ipej.2021.05.001. Epub 2021 May 8.

DOI:10.1016/j.ipej.2021.05.001
PMID:33971284
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8263326/
Abstract

The 12-lead electrocardiogram (ECG) of a 79-year-old male patient with recurrent pre-syncope showed irregular sinus rhythm with constant PR interval and left bundle branch block (LBBB) with intermittently blocked P waves. The beat following the blocked P wave had a narrower QRS with a shorter PR interval. The phenomenon of bilateral bundle branch block explains the sudden improvement in the atrioventricular conduction.

摘要

一名79岁复发性先兆晕厥男性患者的12导联心电图显示窦性心律不齐，PR间期恒定，左束支传导阻滞（LBBB），P波间歇性阻滞。P波阻滞之后的搏动QRS波群变窄，PR间期缩短。双侧束支传导阻滞现象解释了房室传导的突然改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bb4/8263326/00998cbdaea9/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bb4/8263326/1c812495148b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bb4/8263326/473aab798ac1/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bb4/8263326/00998cbdaea9/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bb4/8263326/1c812495148b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bb4/8263326/473aab798ac1/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bb4/8263326/00998cbdaea9/gr3.jpg

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本文引用的文献

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Old teaching tools should not be forgotten: The value of the Lewis ladder diagram in understanding bigeminal rhythms.旧的教学工具不应被遗忘：刘易斯阶梯图在理解二联律节律中的价值。
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