Shimizu A, Fukatani M, Centurion O A, Konoe A, Isomoto S, Kaibara M, Yano K
Third Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Pacing Clin Electrophysiol. 1993 Jan;16(1 Pt 1):39-45. doi: 10.1111/j.1540-8159.1993.tb01533.x.
We report a patient with slow-fast atrioventricular (AV) nodal reentrant tachycardia, in which double ventricular response was demonstrated during rapid pacing at cycle length of 300 msec or less from the high right atrium. The determinants of double ventricular response during transient entrainment in the present case were: (1) a crucial conduction delay in the slow pathway; (2) the collision between the activation via the antegrade fast pathway (antidromically) of the last paced beat and the activation via the antegrade slow pathway (orthodromically) of the previous paced beat, instead of the unidirectional block in the slow pathway; and (3) the enhanced AV nodal conduction over the antegrade fast pathway.
我们报告了一名患有快慢型房室结折返性心动过速的患者，在从高位右心房以300毫秒或更短的周期长度进行快速起搏时，出现了双心室反应。本例中短暂拖带期间双心室反应的决定因素为：（1）慢径路存在关键传导延迟；（2）最后一个起搏搏动经前向快径路（逆向）的激动与前一个起搏搏动经前向慢径路（顺向）的激动发生碰撞，而非慢径路的单向阻滞；（3）前向快径路的房室结传导增强。
