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库梅尔征反转：其机制是什么？

Coumel's sign reversed: What is the mechanism?

作者信息

Bootla Dinakar, Jain Ashish, Mittal Gaurav Kumar, Selvaraj Raja J

机构信息

Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

出版信息

Indian Pacing Electrophysiol J. 2022 Mar-Apr;22(2):115-117. doi: 10.1016/j.ipej.2021.11.007. Epub 2021 Nov 24.

DOI:10.1016/j.ipej.2021.11.007
PMID:34826604
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8981158/
Abstract

A patient presented with documented narrow QRS tachycardia. During electrophysiological study, he has orthodromic reciprocating tachycardia with atrial activation consistent with left free wall accessory pathway. With induction of tachycardia, beats with LBBB morphology have shorter cycle length than those with narrow QRS. What is the mechanism?

摘要

一名患者被记录为窄QRS波心动过速。在电生理研究期间，他发生了顺向型房室折返性心动过速，心房激动与左游离壁旁路一致。诱发心动过速时，呈左束支传导阻滞（LBBB）形态的搏动的周期长度比窄QRS波搏动的周期长度短。其机制是什么？

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e19a/8981158/58b9e44b1cf7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e19a/8981158/846484f4ee76/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e19a/8981158/71d7e8d20f71/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e19a/8981158/58b9e44b1cf7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e19a/8981158/846484f4ee76/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e19a/8981158/71d7e8d20f71/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e19a/8981158/58b9e44b1cf7/gr3.jpg

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引用本文的文献

1
Detailed mechanism of the paradoxical Coumel phenomenon in a case of orthodromic reciprocating tachycardia.一例顺向性折返性心动过速中矛盾性库梅尔现象的详细机制。
HeartRhythm Case Rep. 2024 Feb 8;10(4):288-291. doi: 10.1016/j.hrcr.2024.02.002. eCollection 2024 Apr.

本文引用的文献

1
Functional bundle branch block and orthodromic reciprocating tachycardia cycle length: do not bet on accessory pathway location.功能性束支阻滞与顺向型房室折返性心动过速周期长度：勿依赖旁路位置进行判断。
Europace. 2007 Oct;9(10):920-2. doi: 10.1093/europace/eum183. Epub 2007 Sep 5.
2
Reciprocating tachycardia in overt and latent preexcitation. Influence of functional bundle branch block on the rate of the tachycardia.显性和隐匿性预激中的折返性心动过速。功能性束支阻滞对心动过速速率的影响。
Eur J Cardiol. 1974 Apr;1(4):423-36.