Department of Electrocardiography, Dancheng County Central Hospital, Zhoukou, China.
Department of Electrocardiography, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Ann Noninvasive Electrocardiol. 2022 Sep;27(5):e12959. doi: 10.1111/anec.12959. Epub 2022 Apr 16.
One-to-one atrioventricular conduction during atrial flutter is one of the most severe life-threatening arrhythmias and is hemodynamically perilous. Rapid wide QRS tachycardia often not only occurs in patients with ventricular tachycardia but is also found in supraventricular tachycardia/atrial flutter with preexistent QRS prolongation, supraventricular tachycardia/atrial flutter with QRS prolongation caused by an IC antiarrhythmic drug, and supraventricular tachycardia/atrial flutter with preexcitation. Furthermore, atrial flutter with 1:1 AVC via an accessory pathway is an uncommon presentation of Wolff-Parkinson-White syndrome. We present a case of atrial flutter with 1:1 rapid AVC in the presence of Wolff-Parkinson-White syndrome. Physicians should be familiar with the rapid wide QRS complex ECG pattern associated with AFL with 1:1 AVC via an accessory pathway. Establishing the definitive diagnosis is essential for selecting an appropriate treatment strategy for improving outcomes.
心房扑动时的 1:1 房室传导是最严重的危及生命的心律失常之一，具有血流动力学危险。快速宽 QRS 心动过速不仅常发生于室性心动过速患者，也可见于预激综合征伴前传 QRS 波延长、预激综合征伴 QRS 波延长的抗心律失常药物、预激综合征伴前传的房性或室上性心动过速/心房扑动。此外，伴有旁路前传的 1:1 房室传导的心房扑动是 Wolff-Parkinson-White 综合征的一种不常见表现。我们报告了一例伴有 Wolff-Parkinson-White 综合征的 1:1 快速房室传导的心房扑动。医生应该熟悉与伴有旁路前传的 1:1 房室传导的心房扑动相关的快速宽 QRS 复合波心电图模式。明确诊断对于选择改善预后的适当治疗策略至关重要。
