预激综合征并发房室阻滞和束支阻滞PJ间期的分析

目的探讨预激综合征并发传导阻滞心电图PJ间期的变化。方法选经导管射频消融术（RFCA）治愈的显性预激综合征并发传导阻滞者10例,分为3组,即旁路（AP）位于束支阻滞（BBB）同侧组,旁路位于BBB异侧组及并发Ⅰ°房室阻滞（AVB）组。分别测量各组术前、术后的PJ间期并比较PJ间期变化。结果①6例旁路与BBB位于同侧的患者,术前PJ间期明显短于术后[（230±27）ms比（285±27）ms,P<0.01],但其中1例术前PJ间期为270ms（>260ms）;②2例AP与BBB位于异侧的患者,术前PJ间期短于术后（P<0.01）;③2例并发Ⅰ°AVB的患者,术前PJ间期明显短于术后PJ间期（P<0.01）。结论①预激综合征并发BBB时,PJ间期的变化取决于AP与正路的时差,AP与BBB的位置及AP距离心室最晚激动部位的远近,不能仅从AP的位置与BBB部位的关系来反映PJ的长短;②PJ间期的延长有可能为并发室内阻滞或AVB,宜进一步作食管心房调搏检查以明确诊断。

Analysis of PJ intervals in patients with Wolff-Parkinson-White syndrome associated with bundle branch block or atrioventricular block

AIM To observe the effect of accessory pathway (AP) conduction on the PJ interval in patients with Wolff-Parkinson-White syndrome associated with bundle branch block (BBB) or atrioventricular block(AVB). METHODS Included in the study were 10 patients with a single manifest AP associated with BBB or AVB who had undergone successful radiofrequency ablation (RFCA). The PR intervals,QRS durations and the PJ intervals were measured using simultaneous 12-lead ECG before and after ablation. The effect of AP conduc...