Bharati S, Bauernfiend R, Scheinman M, Massie B, Cheitlin M, Denes P, Wu D, Lev M, Rosen K M
Circulation. 1979 Mar;59(3):593-606. doi: 10.1161/01.cir.59.3.593.
Serial sections of the conduction system (CS) were performed in two patients with recurrent tachyarrhythmias. Case 1, a 34-year-old female who had dual atrioventricular (AV) nodal pathways with recurrent paroxysmal supraventricular tachycardia, committed suicide. Autopsy revealed an abnormally formed atrial septum with insertion of eustachian valve on the AV part of the pars membranacea. The intercuspid portion of the pars membranacea was muscular. The AV node was located adjacent to the membranous part of the ventricular septum rather than the central fibrous body. In addition, there was an accessory anterior AV node on the parietal wall of the right atrium. Case 2, a 13-year-old boy with history of recurrent ventricular tachycardia, died suddenly. CS revealed a right-sided, markedly septated bundle. The first part of right bundle branch was divided into three parts, which later joined together. Both cases showed fatty infiltration of the atrial septum, more than normal for the age of the patients. The relationship of the recurrent tachyarrhythmias to the congenital abnormalities in the CS in the two cases and the fatty infiltration is reviewed.
对两名反复出现心律失常的患者的传导系统（CS）进行了连续切片检查。病例1为一名34岁女性，患有双房室（AV）结径路并反复发生阵发性室上性心动过速，后自杀身亡。尸检发现房间隔形态异常，在膜部的房室部分有欧氏瓣附着。膜部的瓣间部分为肌肉组织。房室结位于室间隔膜部附近而非中心纤维体处。此外，右心房前壁存在一个副房室结。病例2为一名13岁男孩，有反复室性心动过速病史，突然死亡。传导系统检查显示右侧有明显分隔的束支。右束支的第一部分分为三支，随后又汇合在一起。两例均显示房间隔有脂肪浸润，超过了患者年龄的正常范围。本文对两例患者反复出现的心律失常与传导系统先天性异常及脂肪浸润之间的关系进行了综述。
