Sasaki Y, Suyama K, Aruga M, Furuta S
Second Department of Internal Medicine, Shinshu University School of Medicine, Nagano, Japan.
J Electrocardiol. 1995 Jan;28(1):63-8. doi: 10.1016/s0022-0736(05)80009-3.
A 65-year-old woman who had shown no delta waves or atrioventricular block when seen in February 1989, suddenly developed advanced atrioventricular block in April 1990. The first electrophysiologic study revealed that atrioventricular block was caused by His ventricular block, and only weak retrograde conduction was documented. A DDD-type permanent pacemaker was implanted. One month after implantation, delta waves developed. The second electrophysiologic study, performed in February 1993, disclosed that a Kent bundle with bidirectional conduction capacity was located at the posterior septum and that the normal conduction system remained blocked at the His ventricular site. The etiology of the newly developed delta waves seems to be the disappearance of impedance mismatch at the ventricular insertion site of the Kent bundle.
一名65岁女性，1989年2月就诊时未出现δ波或房室传导阻滞，1990年4月突然出现高度房室传导阻滞。首次电生理研究显示，房室传导阻滞由希氏束-心室阻滞引起，仅记录到微弱的逆向传导。植入了DDD型永久性起搏器。植入后1个月，出现了δ波。1993年2月进行的第二次电生理研究表明，具有双向传导能力的肯特束位于后间隔，正常传导系统在希氏束-心室部位仍处于阻滞状态。新出现的δ波的病因似乎是肯特束心室插入部位阻抗失配的消失。
