Veress G
Allami Kórház, Balatonfüred.
Orv Hetil. 1994 May 22;135(21):1131-6.
This report deals with a patient with concealed Wolff-Parkinson-White syndrome in whom both narrow and wide QRS tachycardias were observed. The simultaneous occurrence of various QRS morphology during supraventricular tachycardia results in a challenging diagnostic ECG problem. The cycle length during tachycardia with left bundle branch block was longer than the cycle length during narrow QRS supraventricular tachycardia and with functional right bundle-branch block. Electrophysiologic studies revealed fixed V-A conduction time and increased V-A conduction during tachycardia with left bundle branch block. These studies suggested the presence of a concealed left-sided anomalous pathway. Differentiation between intra- and extranodal re-entry and therapeutic modalities are also discussed.
本报告涉及一名隐匿性预激综合征患者，该患者出现了窄QRS波和宽QRS波心动过速。室上性心动过速期间各种QRS形态同时出现，给心电图诊断带来了挑战。左束支传导阻滞心动过速期间的心动周期长度长于窄QRS波室上性心动过速和功能性右束支传导阻滞期间的心动周期长度。电生理研究显示，左束支传导阻滞心动过速期间存在固定的室房传导时间且室房传导增加。这些研究提示存在隐匿性左侧旁路。文中还讨论了结内和结外折返的鉴别以及治疗方式。
