Ross D L, Wiener I, Farre J, Bar F W, Vanagt E J, Wellens H J
Am J Cardiol. 1981 May;47(5):1173-7. doi: 10.1016/0002-9149(81)90231-9.
A 30 year old woman with Wolff-Parkinson-White syndrome underwent electrophysiologic study for investigation of circus movement tachycardia utilizing the accessory pathway for retrograde conduction. The accessory pathway was located on the right side. Episodes of circus movement tachycardia with left and right bundle branch block were induced. Some episodes of circus movement tachycardia with left bundle branch block terminated spontaneously. Two episodes of spontaneous termination at the level of the atrioventricular (A-V) node were preceded by prolongation of the H-V interval causing delay in atrial activation. This delayed atrial cycle was then followed paradoxically by spontaneous termination of the tachycardia in the A-V node. A similar phenomenon could be demonstrated reproducibly with single echo beats induced by coronary sinus extrastimuli. It appears that retrograde concealed penetration of the A-V node through the bundle branch system during anterograde left bundle branch block is the most likely mechanism for this phenomenon.
一名患有预激综合征的30岁女性接受了电生理研究，以利用附加通道进行逆向传导来研究折返性心动过速。附加通道位于右侧。诱发了伴有左、右束支传导阻滞的折返性心动过速发作。一些伴有左束支传导阻滞的折返性心动过速发作自行终止。在房室（A-V）结水平的两次自发终止之前，H-V间期延长，导致心房激动延迟。然后，这种延迟的心房周期之后，心动过速在房室结中反而自发终止。通过冠状窦额外刺激诱发的单次回声搏动可重复地证明类似现象。看来，在顺向性左束支传导阻滞期间，房室结通过束支系统的逆向隐匿性穿透是这种现象最可能的机制。
