Wu J M, Wang J N, Lin C S, Lee W L
Department of Pediatrics, National Cheng-Kung University Hospital, Tainan, Taiwan, ROC.
J Formos Med Assoc. 1997 Nov;96(11):921-4.
Trifascicular block, which consists of impaired conduction in the three main fascicles of the ventricular conduction system, may progress to high-grade or complete atrioventricular block. It rarely occurs in children with a structurally normal heart. We report a case of trifascicular block in a previously healthy 9-year-old girl. The patient presented with repetitive seizures. The electrocardiogram showed a complete right bundle branch block, left axis deviation, PR interval prolongation, and intermittent high-degree and complete atrioventricular block. She was successfully treated with a temporary pacemaker and her electrocardiogram returned to a normal sinus rhythm in 3 days. She has remained well over a 4-year follow-up. Although her cardiac enzyme levels were normal, the clinical course and electrocardiography findings suggested myocarditis. We emphasize the diagnosis of trifascicular block using electrocardiography; clinical outcome is good, if the patient is managed properly.
三分支阻滞由心室传导系统的三个主要分支传导受损组成，可能进展为高度或完全性房室传导阻滞。它很少发生在心脏结构正常的儿童中。我们报告一例9岁健康女孩发生三分支阻滞的病例。该患者出现反复癫痫发作。心电图显示完全性右束支传导阻滞、电轴左偏、PR间期延长以及间歇性高度和完全性房室传导阻滞。她通过临时起搏器成功治疗，3天后心电图恢复为正常窦性心律。在4年的随访中她一直状况良好。尽管她的心肌酶水平正常，但临床病程和心电图表现提示心肌炎。我们强调使用心电图诊断三分支阻滞；如果对患者进行妥善管理，临床结局良好。
