Greene H L, Reid P R, Schaeffer A H
Am J Cardiol. 1980 Feb;45(2):227-35. doi: 10.1016/0002-9149(80)90640-2.
The electrophysiologic characteristics of the repetitive ventricular response that followed an electrically induced single premature ventricular complex were evaluated to determine its mechanism during atrial pacing or sinus rhythm in 30 patients. Seven patients had preexisting bundle branch block. His bundle or right bundle branch deflections did not precede the repetitive complex in 29 of the 30 patients, which implies that the proximal His-Purkinje system was not involved in the reentry circuit. In 24 of 30 patients the QRS axis ot the repetitive complex was divergent 45 degrees or more from the stimulated complex. In 22 of 30 patients the reprtitive complex had a right bundle branch block configuration. In 14 of 18 patients with two or more repetitive complexes, the QRS pattern changed from beat to beat, which implies that either the reentry pathway or conduction was changing. Thus, the repetitive ventricular response, which can be associated with clinically important ventricular arrhythmias, probably represents intraventricular rather than proximal His-Purkinje system reentry.
对30例患者在心房起搏或窦性心律时，电诱发单个室性早搏后出现的重复性心室反应的电生理特性进行评估，以确定其机制。7例患者存在束支传导阻滞。在30例患者中的29例，希氏束或右束支波峰在重复性复合波之前未出现，这意味着近端希氏 - 浦肯野系统未参与折返环。在30例患者中的24例，重复性复合波的QRS轴与受刺激复合波的QRS轴相差45度或更多。在30例患者中的22例，重复性复合波呈右束支传导阻滞图形。在有两个或更多重复性复合波的18例患者中的14例，QRS图形逐搏改变，这意味着折返途径或传导在改变。因此，可与临床上重要的室性心律失常相关的重复性心室反应，可能代表心室内而非近端希氏 - 浦肯野系统折返。
