Verbeet Thierry, Nguyen Thomas, Almorad Alexandre, Jottrand Maurice, Wauters Thierry, Castro José
Department of Cardiology, University Hospital Brugmann, 1020 Brussels, Belgium.
Department of Cardiology, La Médicale Montgomery, 1150 Brussels, Belgium.
Oxf Med Case Reports. 2021 Oct 26;2021(10):omab093. doi: 10.1093/omcr/omab093. eCollection 2021 Oct.
Paroxysmal atrial tachycardia usually presents as a sudden acceleration of the atrial rate combined with modifications of the P wave morphology. A 22-year-old patient presented with very fast and very slow atrial ectopic activity. He complained of repetitive episodes of fast tachycardia, some accompanied with dizziness. When the ectopic discharge was slow, no clear-cut difference between the sinus rate and the ectopic rate was seen and thus the atrial rhythm appeared quite regular. The ectopic focus was situated deep inside the right upper pulmonary vein (RSPV). After RSPV isolation a persistent sinus rhythm was established and since then the patient has been asymptomatic for 3 years. Thus, subtle changes in the P wave morphology without a significant change in the heart rate in patients presenting with palpitations can give a clue to the diagnosis of the tachycardia and the localization of the ectopic focus.
阵发性房性心动过速通常表现为心房率突然加速，并伴有P波形态改变。一名22岁患者出现极快和极慢的房性异位活动。他主诉反复出现快速心动过速发作，有些伴有头晕。当异位放电缓慢时，窦性心律与异位心律之间未见明显差异，因此心房节律显得相当规则。异位起搏点位于右上肺静脉（RSPV）深处。在RSPV隔离后建立了持续的窦性心律，从那时起患者已无症状3年。因此，心悸患者中P波形态有细微变化而心率无明显变化，可为心动过速的诊断和异位起搏点的定位提供线索。
