房室结双径路传导所致特殊心电图改变

为了解房室结双径路传导所致的较为特殊心电图改变,对食管电生理检查中发现的双径路传导和房室结内折返性心动过速进行分析。发现:(1)双径路传导可以造成不同程度的假性房室传导阻滞,(2)双径路同步1:2房室传导可造成交接区和室性心律失常的假象,(3)在房室结内折返性心动过速发生上部和下部共同径路传导阻滞时又可使心电图表现复杂化。上述改变对进一步认识房室结双径路传导与心律失常的关系有重要意义,能显著提高对房室结双径路传导的正确诊断。

Specific changes in electrocardiogram caused by conduction in dual atrioventricular nodal pathways

In order to investigate specific ECG changes caused by dual AV nodal conduction, we analysed dual AV nodal conduction and AV reentrant tachycardia in esophageal electrophysiologie tests. Results showed : (1) Dual AV nodal conduction could cause pseudoutrioventricular block in different degrees; (2) Synchronistic 1:2 AV conduction in dual AV nodal pathways might cause pseudomorph of junctional and ventricular arrhythmia; (3) Proximal or distal common pathway block in AV reentrant tachycardia could complicate ECG characteristics. These changes are very important in evaluating relationship between dual AV nodal conduction and arrhythmia and very helpful in diagnosis of dual AV nodal pathways.