RonP激发室速或室颤—附3例报告

本文报告了3例室性早搏R波落在P波上(RonP现象)引起室性心动过速。并结合文献复习,讨论了RonP现象予告室速或室颤的价值。认为RonP现象对予告室速或室颤比RonT现象敏感,有其特殊的价值。值得临床工作者重视。本文并对其机理进行了探讨。认为缺血的心肌或病变的心肌其易损期扩大到心动周期的大部分,故RonP可以激发室速或室颤,特别是舒张晚期的早搏则能够出现传导减慢及单向阻滞易产生持续折返,从而可以解释为什么RonP现象引起室速或室颤高于RonT现象。

THE PHENOMENON OF R ON P STIRS THE DEVELOPMENT OF VENTRICULAR TACHYCARDIA AND VENTRICULAR FIBRILLATION (THREE CASES REPORTED)

Three cases suffering from ventricular tachycardia because of the R wave of premature ventricular contraction on the P wave (R on P) were reported. The significance of the phenomenon of R on P for prevising the development of ventricular tachycardra or ventricular fibrillat on was discussed, and the literature was reviewed. It is considered that the phenomenon of R on P is more sensitive than that of R on T in prevising the development of ventricular tachycardla and ventricular fibrillation. It is an important phenomenon and worth studying. The mechanism of development of ventricular tachycardia and ventricular fibrillation caused by R on P was approached. We came to the conduction that the vulnerable period prolonged and covered almost whole cardiac cycle in the ischemic and injured myocardium, so that the slow conduction and unidirect cnal block occured, the continuous reentry would arise, especially when the premature ventricular contraction developed in the late diastolic period. That is why the phenomenon of ventricular tachycardia and ventricular fibrillation caused by R on P is more common than that of ventricular tachycardia and ventricular fibrillation caused by R on T.