Murabit I, Sosa E, Pileggi F, Denes P
Am Heart J. 1986 Jan;111(1):69-80. doi: 10.1016/0002-8703(86)90555-7.
The electrophysiologic studies of three patients with accessory pathways and multiple reentrant circuits are reported. The first patient had two atrioventricular accessory pathways: a left posterior capable of bidirectional conduction and a right paraseptal with retrograde conduction only. Four atrioventricular reentry circuits were documented: left and right orthodromic circuits and a left antidromic circuit with retrograde conduction over the right paraseptal accessory pathway. The second patient had a left lateral atrioventricular accessory pathway with type A preexcitation. Two reentrant tachycardias were noted: an atrial tachycardia where the accessory pathway remained concealed and an orthodromic atrioventricular tachycardia. The third patient had dual atrioventricular nodal pathways and a right nodofascicular accessory pathway. The accessory pathway became manifest only when a critical atrioventricular delay was reached, indicating its association with the slow atrioventricular nodal pathway. Wide QRS tachycardia with left bundle branch block contour was documented, by means of the slow atrioventricular nodal pathway and nodofascicular fiber antegradely, and the proximal right bundle branch, the His bundle, and the fast atrioventricular nodal pathway retrogradely.
报告了3例伴有附加通路和多个折返环患者的电生理研究情况。首例患者有两条房室附加通路：一条左后附加通路，能够双向传导；一条右旁间隔附加通路，仅能逆向传导。记录到4条房室折返环：左、右正向传导环以及一条左向逆向传导环，后者经右旁间隔附加通路逆向传导。第二例患者有一条伴A型预激的左外侧房室附加通路。记录到两种折返性心动过速：一种是附加通路保持隐匿的房性心动过速，另一种是房室正向折返性心动过速。第三例患者有双房室结通路和一条右结-纤维束附加通路。该附加通路仅在达到临界房室延迟时才显现，提示其与慢房室结通路相关。记录到呈左束支传导阻滞图形的宽QRS波心动过速，其通过慢房室结通路和结-纤维束纤维顺向传导，经右束支近端、希氏束和快房室结通路逆向传导。
