Desoutter P, Stoltz J P, Vincent P, Delamare J, Haïat R
Arch Mal Coeur Vaiss. 1981 Dec;74(12):1477-85.
A 24 year old female presented with paroxysmal pseudo-ventricular tachycardia with wide QRS complexes and complete atrioventricular dissociation. Electrophysiological studies showed a junctional tachycardia with an antidromic reciprocating rhythm. The activation involved Mahaïm nodo-ventricular fibres in the anterograde direction, the nodo-hisian pathway being the retrograde limb of the reentry pathway. The main point of interest of this case was the presence of complete atrioventricular dissociation during tachycardia, the atria remaining in sinus rhythm with the possibility of sinus capture formally excluding the diagnosis of a paraseptal Kent bundle. This reentry mechanism has been previously described and constitutes a differential diagnosis of ventricular tachycardia.
一名24岁女性出现阵发性假性室性心动过速，QRS波群增宽，完全性房室分离。电生理研究显示为交界性心动过速伴逆向折返节律。激动沿Mahaim结室纤维前传，结希氏束径路为折返径路的逆传支。该病例的主要关注点是心动过速时存在完全性房室分离，心房保持窦性心律，有窦性夺获的可能，从而正式排除了间隔旁肯特束的诊断。这种折返机制此前已有描述，是室性心动过速的鉴别诊断之一。
