Gonzalez R, Scheinman M M, Desai J, Kersh E, Peters R W
J Electrocardiol. 1980;13(1):85-92. doi: 10.1016/s0022-0736(80)80016-1.
A patient was admitted to the hospital with wide complex tachycardia and a history of recurrent palpitations. Electrophysiologic studies showed evidence of dual atrioventricular (AV) accessory pathways. One proved to be an anteroseptal (possible right anterior) pathway probably capable of only unidirectional conduction. The other pathway was in the posterior septum and conducted only in the retrograde direction. The tachycardia circuit involved anterograde conduction via either the AV node-His axis or the anteroseptal pathway and retroconduction over the posteroseptal accessory pathway. In addition, enhanced AV nodal conduction coupled with two accessory AV nodal pathways has rarely been described in English medical literature. Previous reports have carefully described anatomic, electrocardiographic, and electrophysiologic evidence of more than one accessory pathway in patients with the Wolff-Parkinson-White syndrome. The introduction of surgical techniques for ablation of an accessory pathway demands precision in the electrophysiologic evaluation of patients with ventricular preexcitation. Reported herein is a patient with the unique finding of two extranodal accessory pathways and enhanced atrioventricular (AV) nodal conduction (or AV nodal bypass).
一名患有宽QRS波心动过速且有反复心悸病史的患者入院。电生理研究显示存在双房室（AV）旁道。其中一条被证实为前间隔（可能是右前）旁道，可能仅能单向传导。另一条旁道位于后间隔，仅逆向传导。心动过速环路包括经房室结 - 希氏束轴或前间隔旁道的前向传导以及经后间隔旁道的逆向传导。此外，房室结传导增强并伴有两条房室旁道的情况在英文医学文献中鲜有描述。既往报告曾详细描述过 Wolff - Parkinson - White 综合征患者存在多条旁道的解剖学、心电图及电生理证据。用于消融旁道的外科技术的引入要求对心室预激患者进行精确的电生理评估。本文报道了一名具有两条结外旁道及增强的房室（AV）结传导（或房室结旁路）这一独特发现的患者。
