Ward D E, Camm A J, Spurrell R A
Eur J Cardiol. 1979 Feb;9(2):111-27.
3 patients with paroxysmal palpitations had surface electrocardiographic evidence of type B preexcitation with a small positive delta wave in lead V1. At study all patients had an abnormally short H-V interval. Programmed atrial premature stimuli at progressively shorter coupling intervals resulted in prolongation of AV conduction time and increasing preexcitation. In 2 patients early atrial premature stimuli elicited atrial echo beats or sustained tachycardia with preexcited QRS complexes. In these patients the accessory pathway did not appear to be involved in the tachycardia circuit. It is postulated that the site of reentry is within the AV node with preexcitation occurring as the result of conduction in an anomalous node-ventricular pathway. In the 3rd patient, preexcitation occurred within a restricted range of coupling intervals of an atrial premature stimulus. The electrophysiological responses of nodo-ventricular and His-ventricular pathways to atrial stimulation are compared and contrasted.
3例阵发性心悸患者体表心电图有B型预激表现，V1导联有小的正向δ波。研究时所有患者的H-V间期均异常缩短。以逐渐缩短的联律间期进行程控心房早搏刺激，导致房室传导时间延长和预激增加。2例患者早期心房早搏刺激诱发心房回波搏动或伴有预激QRS波群的持续性心动过速。在这些患者中，旁路似乎未参与心动过速环路。据推测，折返部位在房室结内，预激是由异常的结室径路传导所致。第3例患者，心房早搏刺激在有限的联律间期范围内出现预激。比较并对比了结室径路和希氏束-心室径路对心房刺激的电生理反应。
