Slama R, Coumel P, Motté G, Bouvrain Y
Nouv Presse Med. 1975 Dec 27;4(45):3167-72.
The authors studied 35 cases of Bouveret type paroxysmal tachycardia with normal baseline ECB, without any signs of Wolff-Parkinson-White syndrome. In more than half the patients, it seems that it may be stated that the paroxysmal tachycardia is related not to a reciprocal intranodal rhythm, as is said classically, but to a reciprocal rhythm using in the anterograde direction the normal pathways and in a retrograde direction a direct atrio-ventricular bundle in which only retrograde conduction is possible. This explains the absence of any patent preexcitation pattern on tracings in sinus rhythm. The authors particularly stress the value of a sign recorded at the onset of an attack of tachycardia: transient slowing of the rate of the tachycardia when functional bundle branch block is present can only be explained by the existence of a latent preexcitation bundle on the side of the "slowing bundle branch block".
作者研究了35例基础心电图正常、无任何预激综合征迹象的布韦雷氏型阵发性心动过速患者。在超过半数的患者中,似乎可以认为,阵发性心动过速并非如经典所述与结内折返节律相关,而是与一种折返节律有关,该节律在顺行方向使用正常传导途径,在逆行方向使用仅能进行逆行传导的直接房室束。这就解释了窦性心律心电图上为何没有任何明显的预激图形。作者特别强调了在心动过速发作起始时记录到的一个征象的价值:当存在功能性束支传导阻滞时,心动过速速率的短暂减慢只能通过“减慢束支阻滞”一侧存在潜在的预激束来解释。