Izumi K
J Electrocardiol. 1987 Jan;20(1):45-50. doi: 10.1016/0022-0736(87)90007-0.
A rare case of atrio-ventricular (A-V) junctional parasystole with a quinquageminy and a trigeminy in the presence of a right bundle branch block (RBBB) is reported, in which the ectopic beats showed the same QRS complex as that of the conducted sinus beats. After taking a bath and after intravenous administration of 1.0 mg of atropine, viz. the maneuver to block the vagal effects, the short interectopic interval shortened from control of 2.65-2.70 sec to 2.08 sec, when the shortest interval of 0.98 sec was observed. Thus, the short interectopic intervals resulted from a 2:1 exit block. When the intrinsic ectopic cycle length was about 1.52 sec, the second of four intervening sinus beats in quinquageminy reset the parasystolic pacemaker and a 2:1 exit block ensued, which was attributed to entrance block failure due to a supernormal phase of excitability and conductivity in the His bundle.
报道了1例罕见的房室交接区并行心律，伴有右束支传导阻滞（RBBB）时的五联律和三联律，其中异位搏动的QRS波群与窦性下传搏动的QRS波群相同。洗澡后及静脉注射1.0 mg阿托品（即阻断迷走神经作用的操作）后，短异位间期从对照时的2.65 - 2.70秒缩短至2.08秒，此时观察到最短间期为0.98秒。因此，短异位间期是由2:1传出阻滞所致。当固有异位周期长度约为1.52秒时，五联律中四个插入性窦性搏动中的第二个使并行心律起搏器重整，随后出现2:1传出阻滞，这归因于希氏束兴奋性和传导性超常期导致的传入阻滞失败。
