Schweitzer P, Mark H
J Electrocardiol. 1978 Jan;11(1):75-80. doi: 10.1016/s0022-0736(78)80033-8.
A patient with first and second degree atrio-ventricular (A-V) block and left bundle branch block was shown on electrophysiological study to have an intra and infra-His bundle branch block. In addition, this patient also had an A-V nodal bypass tract. The intra-Hisian block was concealed on the resting His bundle electrogram and became evident only during atrial pacing. The A-V nodal bypass was masked on the surface electrocardiogram (ECG) by the associated A-V conduction defect. The clinical significance of A-V bypass and combined block below the A-V node is discussed. The diagnostic value of His bundle electrocardiography in a patient with complex electrophysiological abnormalities is stressed.
一名患有一度和二度房室（A-V）传导阻滞及左束支传导阻滞的患者，经电生理研究显示存在希氏束内及希氏束下分支传导阻滞。此外，该患者还存在一条房室结旁路。希氏束内阻滞在静息希氏束电图上被隐匿，仅在心房起搏时才变得明显。房室结旁路在体表心电图（ECG）上被相关的房室传导缺陷所掩盖。讨论了房室旁路及房室结以下联合阻滞的临床意义。强调了希氏束心电图在具有复杂电生理异常患者中的诊断价值。
