房室结双径路传导的心电图表现

目的探讨房室结双径路传导引起的心电图表现及形成机制。方法回顾性分析19例患者的常规心电图及动态心电图中出现的房室结双径路传导现象。结果观察到6种房室结双径路传导现象：①房性期前收缩或心房颤动诱发慢快型AVNRT，②AVNRT伴2：1房室传导阻滞或功能性束支传导阻滞时不影响心动过速周长，③室性期前收缩诱发慢快型及快慢型AVNRT，④房性期前收缩重整慢快型AVNRT，⑤两条房室结慢径路交替顺传引起的慢快型AVNRT，⑥房室结双径路同步不等速传导引起的1：2房室传导及折返。结论认识这些心电图现象并了解其形成机制，有助于体表心电图诊断房室结双径路传导。

Electrocardiographic Findings of Dual Atrioventricular Nodal Pathway Conduction

Objective To explore electrocardiographic （ECG）findings of dual atrioventricular nodal pathway conduction（DANPC） and their mechanisms. Methods Phenomena of DANPC on ECG or ambulatory ECG was analyzed retrospectively. Results Six kinds of DANPC were identified as follow： ①Atrial premature contraction or atrial fibrillation induced slow-fast type atrioventricular nodal reentrant tachycardia （AVNRT）; ②AVNRT with 2 ： 1 atrioventricular block or functional bundle branch block did not affect tachyoardia cycle length; ③Ventricular premature contraction induced slow-fast and fast-slow type AVNRT; ④Atrial premature contraction reset the rhythm of slow-fast type AVNRT;⑤ Alternating orthodromic conduction through two slow pathways induced slow-fast type AVNRT; ⑥DANPC, with synchronization but unequal velocity, caused 1 ： 2 atrioventricular conduction and reentrant. Conclusion Knowing these ECG findings and their mechanisms may help to diagnose DANPC on surface ECG.