Baedeker W, Wirtzfeld A, Delius W
Basic Res Cardiol. 1976 May-Jun;71(3):337-42. doi: 10.1007/BF01906458.
The case of a patient with Mobitz type II AV-block is presented who suffered from recurrent dizzy spells and syncopal attacks. These episodes were due to intermittent asystoles lasting for 3-17 seconds, and it could be shown that they were triggered by two or more successive premature atrial contractions. The observation that there were no subsidiary escape beats or rhythms during the asystolic intervals and the ECG pattern for the conducted beats (RBBB and LAH) suggest an intraventricular (trifascicular) level of AV-block. The exact analysis of the asystolic pauses makes it likely that these were initiated by the penetration of the premature atrial impulses into the left posterior subdivision of the left bundle (concealed conduction). The present case demonstrates the fact that premature atrial contractions may produce prolonged asystolic attacks in patients with advanced intraventricular conduction disturbances.
本文报告一例莫氏Ⅱ型房室传导阻滞患者，该患者反复出现头晕发作和晕厥。这些发作是由于间歇性心脏停搏持续3 - 17秒所致，并且可以证明它们是由两个或更多连续的房性早搏触发的。在心脏停搏间期未发现次级逸搏或心律以及传导搏动的心电图模式（右束支传导阻滞和左前分支阻滞）提示房室传导阻滞位于室内（三分支）水平。对心脏停搏期的精确分析表明，这些可能是由房性早搏冲动侵入左束支左后分支（隐匿性传导）引发的。本病例证明了房性早搏可在严重室内传导障碍患者中产生延长的心脏停搏发作这一事实。
