Bauernfeind R A, Wu D, Denes P O, Rosen K M
Am J Cardiol. 1978 Sep;42(3):499-505. doi: 10.1016/0002-9149(78)90947-5.
There are limited reported data regarding the occurrence of retrograde block during dual pathway atrioventricular (A-V) nodal reentrant paroxysmal tachycardia. This study describes two patients with this phenomenon. The first patient had 2:1 and type 1 retrograde ventriculoatrial block during the common variety of A-V nodal reentrance (slow pathway for anterograde and fast pathway for retrograde conduction). Fractionated atrial electrograms suggested that the site of block was within the atria. The second patient had type 1 retrograde block (between the A-V node and the low septal right atrium) during the unusual variety of A-V nodal reentrance (slow pathway for retrograde and fast pathway for anterograde conduction). The abolition of retrograde block by atropine suggested that the site of block was within A-V nodal tissue. Both cases demonstrate that intact retrograde conduction is not necessary for the continuation of A-V nodal reentrant paroxysymal tachycardia. Case 2 supports the hypothesis that the atria are not a requisite part of the A-V nodal reentrant pathway.
关于房室结折返性阵发性心动过速双径路时逆行传导阻滞的发生，报道的数据有限。本研究描述了两例出现这种现象的患者。首例患者在常见的房室结折返（前传慢径路、逆传快径路）时出现2∶1及1型逆行室房阻滞。碎裂心房电图提示阻滞部位在心房内。第二例患者在不常见的房室结折返（逆传慢径路、前传快径路）时出现1型逆行阻滞（在房室结与低位间隔右心房之间）。阿托品可消除逆行阻滞，提示阻滞部位在房室结组织内。两例均表明，完整的逆行传导并非房室结折返性阵发性心动过速持续存在所必需。病例2支持心房并非房室结折返径路必要组成部分这一假说。
