Li H G, Klein G J, Natale A, Thakur R K, Yee R
Department of Medicine, University of Western Ontario, London, Canada.
Pacing Clin Electrophysiol. 1994 Jun;17(6):1186-93. doi: 10.1111/j.1540-8159.1994.tb01479.x.
A 55-year-old woman with frequent problematic supraventricular tachycardia is presented. The tachycardia was irregular with predominantly normal QRS morphology and was refractory to multiple antiarrhythmic drugs. At electrophysiology study, the tachycardia was inducible with atrial or ventricular extrastimuli and dual pathways were observed. In contrast to the situation usually seen with dual atrioventricular node physiology, the slow pathway had a longer effective refractory period than the fast pathway and reentrant tachycardia was not induced. Simultaneous conduction over the fast and slow pathways during sinus rhythm was shown to be the mechanism for clinical tachycardia. The tachycardia was successfully treated using radiofrequency ablation of the slow pathway.
本文介绍了一位55岁频繁发作室上性心动过速的女性患者。该心动过速不规则，QRS波形态基本正常，对多种抗心律失常药物均无效。在电生理研究中，心房或心室期外刺激可诱发心动过速，并观察到双径路。与双房室结生理通常所见情况不同，慢径路的有效不应期比快径路长，未诱发折返性心动过速。窦性心律时快慢径路同时传导被证明是临床心动过速的机制。通过射频消融慢径路成功治疗了该心动过速。
