Sclarovsky S, Lewin R, Strasberg B, Agmon J
Chest. 1978 May;73(5):634-7. doi: 10.1378/chest.73.5.634.
Two cases of alternate Wenckebach periods developing during the acute phase of inferior wall myocardial infarction are presented. In both cases, syncope occurred and severe bradyarrhythmia was recorded on the day of admission. Electrophysiologic study performed in one patient and a narrow QRS complex in the other patient during the alternate Wenckebach periods confirmed the atrioventricular node as the level of block. Transverse dissociation of the atrioventricular node with two (or more) levels of block is the most acceptable explanation for this phenomenon. We suggest that alternate Wenckebach periods occurring during the acute phase of inferior wall myocardial infarction is a severe bradyarrhythmia, and prophylactic temporary pacing is recommended.
本文报告两例下壁心肌梗死急性期出现交替性文氏周期的病例。两例患者均在入院当天发生晕厥，并记录到严重缓慢性心律失常。对其中一例患者进行了电生理检查，另一例患者在交替性文氏周期时出现窄QRS波群，证实阻滞部位在房室结。房室结横向分离伴两个（或更多）阻滞水平是对此现象最合理的解释。我们认为，下壁心肌梗死急性期出现的交替性文氏周期是一种严重的缓慢性心律失常，建议进行预防性临时起搏。
