Sobrino J A, del Rio A, Maté I, Sobrino N
Br Heart J. 1977 Feb;39(2):222-5. doi: 10.1136/hrt.39.2.222.
A patient with a peculiar interatrial block is reported. The electrocardiogram showed a short PR interval and negative P waves in II, III, and aVF, which were preceded, 0-07 s earlier, by another positive P wave present in the right praecordial leads which were absent in the limb leads. From the study with His bundle electrograms, high right atrial electrograms, and bipolar oesophageal electrocardiograms, it could be proved that atrioventricular, His-Purkinje, and right intra-atrial conduction were normal, and that P waves recorded in limb leads represented left atrial depolarization; whereas the ones in the right praecordial leads corresponded to right atrial activation. The vectorial analysis from both P waves and atrial potentials showed that the left atrium was activated in a retrograde fashion, because of an interatrial block. This block was bradycardia dependent and it disappeared in the cycles shorter than 800 ms.
报告了一例患有特殊房间传导阻滞的患者。心电图显示PR间期缩短，II、III和aVF导联P波倒置，而在右胸导联出现另一个正向P波，比前者早0.07秒，肢体导联未见该正向P波。通过希氏束电图、高位右房电图和双极食管心电图研究证实，房室传导、希氏-浦肯野传导及右房内传导正常，肢体导联记录的P波代表左房除极，而右胸导联的P波对应右房激动。对两个P波及心房电位的向量分析显示，由于房间传导阻滞，左房呈逆行激动。这种阻滞与心动过缓有关，在短于800毫秒的心动周期中消失。
