Waldo A L, Henthorn R W, Plumb V J, MacLean W A
J Am Coll Cardiol. 1984 Feb;3(2 Pt 1):422-30. doi: 10.1016/s0735-1097(84)80030-3.
An unusual case is presented in which ventricular tachycardia at a rate of 141 beats/min was transiently entrained by rapid atrial pacing at rates of 150, 155 and 160 beats/min, and was interrupted by rapid atrial pacing at a rate of 165 beats/min. During each period of transient entrainment, constant ventricular fusion beats were present except for the last entrained beat, and progressive ventricular fusion (different fusion QRS complexes) was demonstrated when comparing QRS complex configurations during transient entrainment at each pacing rate. Interruption of the ventricular tachycardia was associated with localized conduction block to the right ventricular recording site, followed by activation of that site from a different direction and with a shorter conduction time by the subsequent pacing impulse. These data clearly distinguish transient entrainment of a tachycardia from overdrive suppression of a tachycardia, and strongly suggest that reentry was the underlying mechanism of the ventricular tachycardia.
本文报告了一例罕见病例，室性心动过速（心率为141次/分钟）被150、155和160次/分钟的快速心房起搏短暂拖带，并被165次/分钟的快速心房起搏中断。在每次短暂拖带期间，除最后一个被拖带的搏动外，均存在恒定的室性融合波，并且在比较每个起搏频率下短暂拖带期间的QRS波群形态时，显示出进行性室性融合（不同的融合QRS波群）。室性心动过速的中断与右心室记录部位的局部传导阻滞有关，随后该部位被随后的起搏冲动从不同方向激活，且传导时间更短。这些数据清楚地将心动过速的短暂拖带与心动过速的超速抑制区分开来，并强烈提示折返是室性心动过速的潜在机制。
